Pub Date : 2022-10-01Epub Date: 2022-05-10DOI: 10.1177/17531934221098504
Stefanie Frances Gibb Née Andrew, Carol Julie Clark, Zoë Alexandra Sheppard, Timothy Bernard Crook
{"title":"Exploration of rehabilitation through the use of virtual reality interventions for patients with hand conditions: a scoping review.","authors":"Stefanie Frances Gibb Née Andrew, Carol Julie Clark, Zoë Alexandra Sheppard, Timothy Bernard Crook","doi":"10.1177/17531934221098504","DOIUrl":"10.1177/17531934221098504","url":null,"abstract":"","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"47 1","pages":"970-971"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45911074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-14DOI: 10.1177/17531934221101770
M. Cabrera-González, D. Gutiérrez-de la Iglesia, C. G. Fontecha, Rocio G Garcia, A. Ortega-Centol, L. M. Perez-Lopez
The aim of this study was to present a classification of Poland syndrome deformities, which we hypothesized was simple, valid, reliable and useful in planning surgery. We retrospectively reviewed 74 patients with Poland syndrome treated in our centre between 1990 and 2019 (inclusive). The proposed classification comprised six types of ascending severity and was based on clinical and radiological findings. Agreement with the frequently used but more complex Catena classification was substantial (kappa 0.70), and interobserver reliability was close to perfect (kappa 0.87). The severity of the deformities according to this classification correlated well with the number of surgeries performed, except for Type 5, in which the result of surgery often is disappointing, and in Type 6, that is beyond the reach of surgical treatment. We conclude that this classification is useful in planning surgery and in advising parents on the surgical strategy. Level of evidence III
{"title":"Poland syndrome: a new classification system based on a retrospective analysis of 74 cases","authors":"M. Cabrera-González, D. Gutiérrez-de la Iglesia, C. G. Fontecha, Rocio G Garcia, A. Ortega-Centol, L. M. Perez-Lopez","doi":"10.1177/17531934221101770","DOIUrl":"https://doi.org/10.1177/17531934221101770","url":null,"abstract":"The aim of this study was to present a classification of Poland syndrome deformities, which we hypothesized was simple, valid, reliable and useful in planning surgery. We retrospectively reviewed 74 patients with Poland syndrome treated in our centre between 1990 and 2019 (inclusive). The proposed classification comprised six types of ascending severity and was based on clinical and radiological findings. Agreement with the frequently used but more complex Catena classification was substantial (kappa 0.70), and interobserver reliability was close to perfect (kappa 0.87). The severity of the deformities according to this classification correlated well with the number of surgeries performed, except for Type 5, in which the result of surgery often is disappointing, and in Type 6, that is beyond the reach of surgical treatment. We conclude that this classification is useful in planning surgery and in advising parents on the surgical strategy. Level of evidence III","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"47 1","pages":"1027 - 1031"},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43138943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-14DOI: 10.1177/17531934221105225
D. Roberts, R. Jose, L. Duraku, Matthew j wordsworth, M. Foster, D. Mortiboy, E. Sellon, S. Stapley, D. Power
This is the second of a two-part review article on the management of conflict injuries, focused on the reconstructive strategies for bone, nerve and soft tissue and to provide guidance on assessing and managing common complications associated with complex upper limb injuries. Following assessment and early surgical management, the conflict casualty will require further wound evaluation and planning prior to definitive reconstruction of limb injuries. Surgical management of the upper limb injury should aim, where possible, to preserve the limb and allow functional reconstruction. The principles of the second look procedure are to assess wound progression, further reduce the risk of infection and plan definitive reconstruction with adequate soft tissue cover. The prerequisites for successful surgical reconstruction are a stable patient, combined orthoplastic surgery expertise supported by physiotherapists and hand therapists.
{"title":"Management of conflict injuries to the upper limb. Part 2: reconstruction and managing complications","authors":"D. Roberts, R. Jose, L. Duraku, Matthew j wordsworth, M. Foster, D. Mortiboy, E. Sellon, S. Stapley, D. Power","doi":"10.1177/17531934221105225","DOIUrl":"https://doi.org/10.1177/17531934221105225","url":null,"abstract":"This is the second of a two-part review article on the management of conflict injuries, focused on the reconstructive strategies for bone, nerve and soft tissue and to provide guidance on assessing and managing common complications associated with complex upper limb injuries. Following assessment and early surgical management, the conflict casualty will require further wound evaluation and planning prior to definitive reconstruction of limb injuries. Surgical management of the upper limb injury should aim, where possible, to preserve the limb and allow functional reconstruction. The principles of the second look procedure are to assess wound progression, further reduce the risk of infection and plan definitive reconstruction with adequate soft tissue cover. The prerequisites for successful surgical reconstruction are a stable patient, combined orthoplastic surgery expertise supported by physiotherapists and hand therapists.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"47 1","pages":"787 - 797"},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43892521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-14DOI: 10.1177/17531934221103688
S. Hashimoto, H. Kato, S. Uchiyama, T. Itsubo, S. Matsuda, M. Hayashi
We evaluated the tendon length and excursion after extensor tendon grafting following ruptures at the distal radioulnar joint in eight patients. The mean patient age was 70.8 years (range 58 to 84), and the mean follow-up period was 63 months (range 12 to 129). Radiographic markers were placed on ends of the grafted tendon to assess changes in length and passive excursion. The mean length of the grafted tendon and mean passive excursion were 68.2 mm and 4.4 mm immediately after tendon grafting, 76.1 mm and 7.1 mm at 1 year postoperatively, and 76.3 mm and 7.3 mm at final follow-up, respectively. The mean elongation of the grafted tendon was 12% and mean increase of excursion was 2.9 mm. We recommend that tension set during extensor tendon grafting should be with the metacarpophalangeal joint of the affected finger in a slightly extended position as compared with adjacent fingers. Level of evidence IV
{"title":"Changes in tendon length and excursion following extensor tendon grafting at the distal radioulnar joint","authors":"S. Hashimoto, H. Kato, S. Uchiyama, T. Itsubo, S. Matsuda, M. Hayashi","doi":"10.1177/17531934221103688","DOIUrl":"https://doi.org/10.1177/17531934221103688","url":null,"abstract":"We evaluated the tendon length and excursion after extensor tendon grafting following ruptures at the distal radioulnar joint in eight patients. The mean patient age was 70.8 years (range 58 to 84), and the mean follow-up period was 63 months (range 12 to 129). Radiographic markers were placed on ends of the grafted tendon to assess changes in length and passive excursion. The mean length of the grafted tendon and mean passive excursion were 68.2 mm and 4.4 mm immediately after tendon grafting, 76.1 mm and 7.1 mm at 1 year postoperatively, and 76.3 mm and 7.3 mm at final follow-up, respectively. The mean elongation of the grafted tendon was 12% and mean increase of excursion was 2.9 mm. We recommend that tension set during extensor tendon grafting should be with the metacarpophalangeal joint of the affected finger in a slightly extended position as compared with adjacent fingers. Level of evidence IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"47 1","pages":"857 - 864"},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47820587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-14DOI: 10.1177/17531934221102666
Gaspard Lebot, Marion Halbaut, C. Chantelot, M. Saab
The aim of our study was to compare the medium-term clinical and functional outcomes of early repair of a complete Zone 2B or 2C transection of the flexor digitorum profundus tendon associated with either the repair of the two slips of the flexor digitorum superficialis tendon, only one slip repaired (the other slip was resected) or no slips repaired (both slips were resected). The outcomes of these three repair techniques were compared based on the total active motion, residual flexion deformity of the proximal interphalangeal joint, Strickland’s formula and Tang classification, Disability of Arm Shoulder and Hand score and complications. The study reviewed 61 fingers (51 patients) at a mean follow-up of 89.5 months. There was no significant difference in finger mobility comparing the three techniques for management of flexor digitorum superficialis. All but one patient returned to work and the DASH score (mean 6.9) suggests that function does not appear to be greatly affected. Level of evidence III
{"title":"Medium-term clinical outcomes of Zone 2B/2C finger flexor tendon repairs: influence of management of flexor digitorum superficialis","authors":"Gaspard Lebot, Marion Halbaut, C. Chantelot, M. Saab","doi":"10.1177/17531934221102666","DOIUrl":"https://doi.org/10.1177/17531934221102666","url":null,"abstract":"The aim of our study was to compare the medium-term clinical and functional outcomes of early repair of a complete Zone 2B or 2C transection of the flexor digitorum profundus tendon associated with either the repair of the two slips of the flexor digitorum superficialis tendon, only one slip repaired (the other slip was resected) or no slips repaired (both slips were resected). The outcomes of these three repair techniques were compared based on the total active motion, residual flexion deformity of the proximal interphalangeal joint, Strickland’s formula and Tang classification, Disability of Arm Shoulder and Hand score and complications. The study reviewed 61 fingers (51 patients) at a mean follow-up of 89.5 months. There was no significant difference in finger mobility comparing the three techniques for management of flexor digitorum superficialis. All but one patient returned to work and the DASH score (mean 6.9) suggests that function does not appear to be greatly affected. Level of evidence III","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"47 1","pages":"1056 - 1063"},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43965581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1177/17531934221101998
A. Anbarasan, T. Takagi, A. Seki, S. Takayama
In this study, we retrospectively reviewed our results of managing the clasped thumb deformity in arthrogryposis multiplex congenita patients with first web space deepening and abductor pollicis brevis (APB) rerouting. Twenty-six thumb deformities in 16 children with a mean age of 6.2 years were treated with a mean follow-up of 89.6 months. Following reconstruction with the Spinner flap, the mean angle of the first and second metacarpal axis (M1M2) showed significant improvement from 42° to 61° indicating a wider first web space, and the postoperative mean angle of the thumb proximal phalanx to its metacarpal axis (M1P1) was reduced from 41° to 18°, indicative of a straighter thumb. Following reconstruction with a double-opposing Z-plasty, the mean M1M2 and M1P1 also improved from 38° to 52° and 18° to 9°, respectively. Rerouting of the APB with first web deepening is an efficient and reproducible procedure in improving thumb position. Level of evidence III
{"title":"Abductor pollicis brevis rerouting and first web deepening for clasped thumb deformity in arthrogryposis multiplex congenita","authors":"A. Anbarasan, T. Takagi, A. Seki, S. Takayama","doi":"10.1177/17531934221101998","DOIUrl":"https://doi.org/10.1177/17531934221101998","url":null,"abstract":"In this study, we retrospectively reviewed our results of managing the clasped thumb deformity in arthrogryposis multiplex congenita patients with first web space deepening and abductor pollicis brevis (APB) rerouting. Twenty-six thumb deformities in 16 children with a mean age of 6.2 years were treated with a mean follow-up of 89.6 months. Following reconstruction with the Spinner flap, the mean angle of the first and second metacarpal axis (M1M2) showed significant improvement from 42° to 61° indicating a wider first web space, and the postoperative mean angle of the thumb proximal phalanx to its metacarpal axis (M1P1) was reduced from 41° to 18°, indicative of a straighter thumb. Following reconstruction with a double-opposing Z-plasty, the mean M1M2 and M1P1 also improved from 38° to 52° and 18° to 9°, respectively. Rerouting of the APB with first web deepening is an efficient and reproducible procedure in improving thumb position. Level of evidence III","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"47 1","pages":"1039 - 1044"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42270638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-31DOI: 10.1177/17531934221102251
P. Nordback, M. Westman, E. Waris
The long-term outcomes of extension block pinning used to treat unstable dorsal fracture-dislocations of the proximal interphalangeal joint have been investigated in a single centre. Thirty-one patients (33 fingers) had a clinical and radiological assessment at a mean follow-up of 16 years. Excluding one joint salvaged with an arthrodesis, the mean active range of motion of the joints was 80° with a mean 5° extension deficit. The mean active range of motion of the distal interphalangeal joint was 64°. The mean Patient-Rated Wrist and Hand Evaluation score was 6, indicating, minimal disability. The mean numeric rating scale for overall subjective pain on a scale of 0–10 was 1 and was not associated with the active range of movement. The Kallman osteoarthritis score and the range of movement of the proximal interphalangeal joint had a negative association. The long-term outcomes were satisfactory and similar to the mid-term follow-up results of the same patient cohort reported 11 years earlier. Level of evidence IV
{"title":"Long-term outcomes after extension block pinning for fracture-dislocations of the proximal interphalangeal joint","authors":"P. Nordback, M. Westman, E. Waris","doi":"10.1177/17531934221102251","DOIUrl":"https://doi.org/10.1177/17531934221102251","url":null,"abstract":"The long-term outcomes of extension block pinning used to treat unstable dorsal fracture-dislocations of the proximal interphalangeal joint have been investigated in a single centre. Thirty-one patients (33 fingers) had a clinical and radiological assessment at a mean follow-up of 16 years. Excluding one joint salvaged with an arthrodesis, the mean active range of motion of the joints was 80° with a mean 5° extension deficit. The mean active range of motion of the distal interphalangeal joint was 64°. The mean Patient-Rated Wrist and Hand Evaluation score was 6, indicating, minimal disability. The mean numeric rating scale for overall subjective pain on a scale of 0–10 was 1 and was not associated with the active range of movement. The Kallman osteoarthritis score and the range of movement of the proximal interphalangeal joint had a negative association. The long-term outcomes were satisfactory and similar to the mid-term follow-up results of the same patient cohort reported 11 years earlier. Level of evidence IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"47 1","pages":"927 - 934"},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44669420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-25DOI: 10.1177/17531934221101716
Julio De Las Heras, J. Sañudo, C. Simon de Blas, Ioannis Krompas, Guillermo José SalaBerri, P. Aragonés
We dissected 192 fingers in 48 fresh cadaveric hands (23 right and 25 left hands from 26 female and 22 male donors) and analysed the incidence, location, length and structure of the five annular and three cruciform pulleys. No statistically significant differences were found between left and right or between male and female hands. The A1, A2 and A4 pulleys were present in all fingers, while the incidence of other pulleys varied. We found 32 different patterns of pulley combinations. The structure of the pulleys also varied. Most important was the variation of A1, which consisted of one to four separate rings. In 18% there was no gap between the A1 and A2 pulleys. A greater understanding of the anatomical variation of the pulley system is beneficial for hand surgeons performing open or percutaneous trigger finger releases and for radiologists examining the area sonographically.
{"title":"The incidence and shape of the digital pulleys: a study of 192 fingers in 48 cadaveric hands","authors":"Julio De Las Heras, J. Sañudo, C. Simon de Blas, Ioannis Krompas, Guillermo José SalaBerri, P. Aragonés","doi":"10.1177/17531934221101716","DOIUrl":"https://doi.org/10.1177/17531934221101716","url":null,"abstract":"We dissected 192 fingers in 48 fresh cadaveric hands (23 right and 25 left hands from 26 female and 22 male donors) and analysed the incidence, location, length and structure of the five annular and three cruciform pulleys. No statistically significant differences were found between left and right or between male and female hands. The A1, A2 and A4 pulleys were present in all fingers, while the incidence of other pulleys varied. We found 32 different patterns of pulley combinations. The structure of the pulleys also varied. Most important was the variation of A1, which consisted of one to four separate rings. In 18% there was no gap between the A1 and A2 pulleys. A greater understanding of the anatomical variation of the pulley system is beneficial for hand surgeons performing open or percutaneous trigger finger releases and for radiologists examining the area sonographically.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"47 1","pages":"818 - 824"},"PeriodicalIF":0.0,"publicationDate":"2022-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45351557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-17DOI: 10.1177/17531934221098916
K. V. Brown, D. Roberts, Matthew j wordsworth, L. Duraku, R. Jose, D. Power, S. Stapley
Upper limb injuries are common in conflict zones. The functions of the upper limb are impossible to replicate with prosthetic replacement and wherever possible attempts should be made to preserve the limb with further secondary reconstruction aimed at restoration of function. Casualty assessment, haemorrhage control and resuscitation are simultaneously undertaken at the receiving medical facility. Primary surgical management involves decontamination and debridement, skeletal stabilization, restoration of vascularity, compartment fasciotomy where indicated and wound temporization with dressings. Operative findings and interventions should be documented and if evacuation of the casualty is possible, copies should be provided in the medical records to facilitate communication in the chain of care. Secondary procedures are required for further assessment and debridement prior to planning reconstruction and definitive fracture stabilization, nerve repair, wound cover or closure.
{"title":"Management of conflict injuries to the upper limb. Part 1: assessment and early surgical care","authors":"K. V. Brown, D. Roberts, Matthew j wordsworth, L. Duraku, R. Jose, D. Power, S. Stapley","doi":"10.1177/17531934221098916","DOIUrl":"https://doi.org/10.1177/17531934221098916","url":null,"abstract":"Upper limb injuries are common in conflict zones. The functions of the upper limb are impossible to replicate with prosthetic replacement and wherever possible attempts should be made to preserve the limb with further secondary reconstruction aimed at restoration of function. Casualty assessment, haemorrhage control and resuscitation are simultaneously undertaken at the receiving medical facility. Primary surgical management involves decontamination and debridement, skeletal stabilization, restoration of vascularity, compartment fasciotomy where indicated and wound temporization with dressings. Operative findings and interventions should be documented and if evacuation of the casualty is possible, copies should be provided in the medical records to facilitate communication in the chain of care. Secondary procedures are required for further assessment and debridement prior to planning reconstruction and definitive fracture stabilization, nerve repair, wound cover or closure.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"47 1","pages":"687 - 697"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42741997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This retrospective study reviewed 28 patients, aged 10 to 17 years, who underwent corrective osteotomy for malunion of the proximal phalangeal distal condyles at a mean of 9 weeks (range 2–52) from injury. There were 19 patients treated with K-wire and nine patients with locking plates. The two groups were comparable for trauma mechanism, fracture type, time delay from injury and the type of initial treatment. The K-wire group had a shorter duration of operation and shorter time to union than the plating group. For both groups, postoperative radiographs showed significant correction, which remained unchanged until the final follow-up (minimum 12 months), although greater residual coronal angulation was found in the K-wire group. The outcomes in 17 of the 28 patients were graded as excellent or good according to the Al-Qattan classification, with no difference between the groups. The complication rate was also similar between the groups, while the locking plate group had a higher rate of secondary surgery. Level of evidence: III
{"title":"Corrective osteotomy for distal condylar malunion of the proximal phalanx in adolescents: comparison of K-wire and locking plate fixation","authors":"Kuan-Jung Chen, Yu-Po Huang, I-Ning Lo, Yi-Chao Huang","doi":"10.1177/17531934221098006","DOIUrl":"https://doi.org/10.1177/17531934221098006","url":null,"abstract":"This retrospective study reviewed 28 patients, aged 10 to 17 years, who underwent corrective osteotomy for malunion of the proximal phalangeal distal condyles at a mean of 9 weeks (range 2–52) from injury. There were 19 patients treated with K-wire and nine patients with locking plates. The two groups were comparable for trauma mechanism, fracture type, time delay from injury and the type of initial treatment. The K-wire group had a shorter duration of operation and shorter time to union than the plating group. For both groups, postoperative radiographs showed significant correction, which remained unchanged until the final follow-up (minimum 12 months), although greater residual coronal angulation was found in the K-wire group. The outcomes in 17 of the 28 patients were graded as excellent or good according to the Al-Qattan classification, with no difference between the groups. The complication rate was also similar between the groups, while the locking plate group had a higher rate of secondary surgery. Level of evidence: III","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":"47 1","pages":"935 - 943"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48078035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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