[Mini-invasive osteosynthesis in injuries of the finger phalangeal bones in children]

Injuries of the skeleton of phalanges of the fingers are along with injuries of the forearm the most frequent fractures in childhood and in the great majority conservative treatment is possible. Only exceptionally primary surgery is needed and if it fails and redislocation occurs, surgical treatment is indicated. Then the method of choice is miniinvasive osteosynthesis--percutaneous fixation. During the period between 1994 and 1998 the authors treated thus 22 patients on account of skeletal injuries of the phalanges. Primarily the method was used in 16 cases, 6x after redislocation of fragments. In 9 instances thus diaphyseal injuries were treated, in 7 cases intercondylar fractures and in 6 instances fractures of the base of the distal fragment. In 18 instances Kirschner wire was used and four times a fragment fixation screw. The general results of treatment were in 16 patients excellent, in 4 instances satisfactory and in two cases unsatisfactory. In one case marked restriction of mobility and stiffness of the joint developed after fixation of an intercondylar fracture and in one instance a mallet finger developed. No serious suppurative complications were observed nor any serious neurovascular complications. The apparent trivial character of the injury and its fixation must not lead to underrating of this type of fracture as it may have permanent sequelae. The latter are not very serious but are a certain handicap. In particular in conjunction with some professions (music) they can have a marked influence on the patient's future.