Davos Courses

Executive Editor: Jörg Auer

Authors: Jörg Auer

Phalanges Distal phalanx, Multifragment

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Glossary

Screw fixation and resection
Main indication Skill Equipment
Regain use of the limb Basic surgical experience, no specialized skills Basic equipment only


Multifragment fractures have generally a guarded to poor prognosis, especially if the fragmentation involves the articular surface. These cases are either euthanatized immediately or treated conservatively.



In cases where the articular fracture line is located in the sagittal plane availability of intraoperative radiography is adequate for the repair.

If the intraarticular fracture line is located abaxially, same technique as described for abaxial fractures is applied.

Occasionally small extensor process fractures are diagnosed as well. These fragments are removed under arthroscopic supervision.



Screw fixation

Selected cases (single articular fracture line) can be treated by means of internal fixation. Availability of intraoperative CT-imaging or fluoroscopy greatly improves precision of screw implantation and ultimately treatment success.

*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

v1.3 2013-11-20