Epidemiology and treatment of phalangeal fractures: conservative treatment is the predominant therapeutic concept

  • Purpose: Despite the high number of patients with phalangeal fractures, evidence-based recommendations for the treatment of specific phalangeal fractures could not be concluded from the literature. The purpose of the present study was to assess current epidemiological data, classification of the fracture type, and mode of treatment. Methods: This study presents a retrospective review of 261 patients with 283 phalangeal fractures ≥ 18 years of age who were treated in our level I trauma centre between 2017 and 2018. The data were obtained by the analysis of the institution’s database, and radiological examinations. Results: The average age of the patients was 40.4 years (range 18–98). The ratio of male to female patients was 2.7:1. The two most typical injury mechanisms were crush injuries (33%) and falls (23%). Most phalangeal fractures occurred in the distal phalanx (P3 43%). The 4th ray (D4 29%) was most frequently affected. The P3 tuft fractures, and the middle phalanx (P2) base fractures each accounted for 25% of fracture types. A total of 74% of fractures were treated conservatively, and 26% required surgery, with Kirschner wire(s) (37%) as the preferred surgical treatment. The decision for surgical treatment correlated with the degree of angular and/or rotational deformity, intraarticular step, and sub-/luxation of specific phalangeal fractures, but not with age and gender. Conclusions: Our findings demonstrated the popularity of conservative treatment of phalangeal fractures, while surgery was only required in properly selected cases. The correct definition of precise fracture pattern in addition to topography is essential to facilitate treatment decision-making.
Author:Laura KremerGND, Johannes FrankORCiDGND, Thomas LustenbergerORCiDGND, Ingo MarziORCiDGND, Anna Lena SanderORCiDGND
Parent Title (English):European journal of trauma and emergency surgery
Publisher:Springer Medizin
Place of publication:Berlin ; Heidelberg
Document Type:Article
Date of Publication (online):2020/05/25
Date of first Publication:2020/05/25
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/07/06
Tag:Classification; Epidemiology; Fracture type; Phalangeal fractures; Treatment
Page Number:5
First Page:567
Last Page:571
Open Access funding provided by Projekt DEAL.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0