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Reverse Instrumentation for Headless Compression Screw Fixation of Basal Proximal Phalangeal Fractures
Brahman Sivakumar1, David J Graham2
1Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, St. Leonards NSW, Australia; Australian Research Collaboration on Hands (ARCH), 4/75 Railway St, Mudgeeraba QLD, Australia; Department of Surgery, Faculty of Medicine, University of Sydney, Camperdown NSW, Australia; Department of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Hornsby NSW, Australia; Department of Orthopaedic Surgery, Nepean Hospital, Kingswood, NSW, Australia.
Abstract:
Intramedullary headless compression screw fixation of proximal phalangeal fractures permits semirigid stabilization through a minimally invasive approach with negligible tendon disturbance, allowing early mobilization and rehabilitation. Antegrade insertion is preferred for basal fractures, but various concerns and technical difficulties have been identified with both intra- and transarticular instrumentation. We describe a technical tip to facilitate easier guidewire insertion and instrumentation with a screw via an intra-articular approach.
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