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High risk of symptomatic implant
57%
2538/4486
Immobilization of the distal interphalangeal joint is required for 2 weeks post-operatively
6%
268/4486
High rates of post-operative infection are common
2%
97/4486
Open reduction via an approach through the nail bed leads to significant post-operative nail deformity
24%
1079/4486
Range of motion of the DIP joint in the affected finger is usually less than 10 degrees post-operatively
10%
471/4486
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Open reduction and internal fixation of distal phalanx fracture non-unions frequently requires the post-operative removal of the fixation implant after complete fracture healing. Chim et al followed 14 patients with non-union of fractures of the shaft of the distal phalanx who were treated with open reduction and screw fixation. The implants required removal in 13/14 patients, and the mean post-operative range of motion of the DIP joints was 56 degrees. No immobilization was required postoperatively, and bone grafting was only necessary in two patients with severely comminuted fractures. Finally, the authors recommended approaching the fracture through the nailbed for the best exposure, and found no postoperative nail growth complications. Postoperative infections were not common in their series. Mejis et al describe two patients with non-unions of the thumb distal phalanx treated with a single compression screw using a minimally invasive approach. Both patients healed their fractures using this technique.
1.8
(74)
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