Arroyo BC, Romo RR

Language: Spanish
References: 9
Page: 37-41
PDF size: 180.60 Kb.

ABSTRACT

Physeal fractures in phalanxes are rare. They account for approximately 37% of hand fractures in the pediatric population. They are more common in boys in early adolescence. About 43% of the fractures involve the proximal phalanx and the metacarpophalangeal articulation is the most vulnerable. The small finger is the most commonly involved (about 30% of the cases) followed by the thumb (20% of the cases). The most common fracture type is Salter and Harris II (54%), which can be treated conservatively. Achieving an adequate reduction and joint congruity to avoid late arthrosis is the primary objective of surgical treatment. Surgical treatment is reserved for Salter and Harris III-IV displaced fractures. There is no gold standard for the surgical approach to treat these fractures. A dorsal or a volar approach can be used. There have been two different descriptions of a volar approach: a trans-web approach and a volar A1 pulley approach. We present the clinical case of a of a fourteen year old patient with a Salter – Harris IV fracture of the base of the proximal phalanx of the little right finger treated by open reduction and percutaneous fixation by a volar approach through the A1 pulley.

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