Closed percutaneous reduction by leverage and Kirschner wire fixation for treatment of irreducible phalangeal neck fractures in children

Objective To investigate the clinical efficacy of closed percutaneous reduction by leverage and Kirschner wire fixation in the treatment of irreducible phalangeal neck fractures in children. Methods From January 2016 to March 2019, 12 children with irreducible phalangeal neck fractures ware treated. The time from injury to operation was 1 to 46 days, including 5 cases of old fracture. Closed Kirschner wire puncture was used to clear callus and closed percutaneous reduction by leverage and Kirschner wire fixation were performed. The fracture healing time of the children was followed up after operation. Total active motion (TAM) system was used to evaluate the recovery of finger function. Results All the operations were completed successfully, and no infection, skin necrosis and fracture malunion occurred. All the children were follow-up for 6 to 36 months, with an average of 15.3 months. The fracture healing time was (4.2±0.2) weeks. The Kirschner wire was removed and functional exercises were performed 4 weeks after operation. The finger joint function was evaluated as excellent according to TAM system. Conclusion Closed percutaneous reduction by leverage and Kirschner wire fixation in the treatment of irreducible phalangeal neck fractures in children has the advantages of simple operation, less trauma and definite curative effect. It is necessary to strictly grasp the operative indications for old fracture. Key words: Finger phalanges; Fractures,bone; Fracture fixation; Kirschner wire