Open Distal Phalanx Tuft Fractures in Fingertip Injuries: A Retrospective Cohort Study Comparing Kirschner Wire...

Area of Science:

• Orthopedic Surgery
• Traumatology

Background:

• Open tuft fractures of the distal phalanx often involve soft-tissue and nail-bed injuries.
• Optimal management, particularly the use of Kirschner wire (K-wire) fixation, remains debated.

Purpose of the Study:

• To compare clinical and functional outcomes of K-wire fixation versus conservative management for open distal phalanx tuft fractures.

Main Methods:

• Retrospective comparative cohort study of 50 adult patients with open distal phalanx tuft fractures.
• Two groups: K-wire fixation (n=25) and conservative management (n=25).
• Outcomes assessed at ≥6 months: radiological union, joint range of motion, pinch strength, pain (VAS), satisfaction, and complications.

Main Results:

• Higher union rate (94% vs 76%) and shorter time to union (5.2 vs 6.8 weeks) with K-wire fixation.
• Significantly better distal interphalangeal joint flexion (65° vs 54°), pinch strength (88% vs 74%), and lower pain scores (1.4 vs 2.8 VAS) in the fixation group.
• Slightly higher patient satisfaction (84% vs 76%) with fixation; conservative group had more delayed union and tenderness.

Conclusions:

• K-wire fixation may provide superior union and functional recovery for open tuft fractures with displaced/unstable fragments and significant nail-bed injury.
• Treatment decisions should be individualized based on injury characteristics and patient factors due to study limitations.