Combined external fixation frames and autologous bone graft reconstruction in thumb proximal phalanx bone loss: A
Sean Curran1,2, Ciaran Hurley1,2, Safwat Ibrahim1,2
1Department of Plastic and Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland.
Background:
Proximal phalangeal fractures with significant bone loss are inherently unstable, often resulting in significant malalignment secondary to the high degree of instability. Often significant bone loss is not amenable to surgical fixation alone and bone grafts are required to maintain length and reconstruct the given defect.
Objective:
This cases series exhibits three cases of fixation of proximal phalanx fractures of the thumb with associated bone loss using an independently constructed external fixation frame in combination with autologous iliac crest bone graft to restore bone stock and digit length.
Methods:
3 patients were included, all of whom suffered proximal phalanx fracture(s) of the thumb with associated bone loss requiring autologous bone graft and external fixation.
Results:
All 3 patients achieved radiographic union. The minimum Kapandi opposition score noted at 1 year postoperatively was 8. No postoperative complications were recorded.
Conclusion:
We believe that our combined approach of iliac crest bone grafting and independently constructed external fixation frame achieves restoration of bone and digit length with simultaneous fracture reduction and stabilization in cases with significant bony destruction.
