Executive Editor: Chris Colton

Authors: Fiesky Nuñez, Renato Fricker, Matej Kastelec, Terry Axelrod

Middle phalanx - Shaft, multifragmentary

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Glossary

General considerations

Comminuted fractures are rarely isolated injuries, as they usually result from high-energy trauma (crushing). Soft-tissue lesions are frequently associated with the potential risk of edema, fibrotic reactions and eventual stiffness.
For these reasons, these injuries are usually treated by ORIF, in order to provide sufficient stability for immediate mobilization, reducing such risks.

Nonoperative treatment
Main indication Skill Equipment
Well aligned phalanx without rotational or axial deformity Basic surgical experience, no specialized skills Basic equipment only

Contraindications

  • Open fractures
  • Rotational or axial deformity
Minicondylar bridge plate fixation
Main indication Skill Equipment
Rotational or axial deformity, open fractures, associated soft tissue injury Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Contraindications

  • Gross contamination
  • Lack of adequate bone stock
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.0 2008-11-08