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Mohammad M Alqattan - One of the best experts on this subject based on the ideXlab platform.
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bi cortical periarticular k Wire Fixation for displaced unstable transverse extra articular fractures of the base of the proximal phalanx of the fingers
Injury-international Journal of The Care of The Injured, 2021Co-Authors: Mohammad M AlqattanAbstract:Abstract Introduction Management of unstable fractures of the proximal phalanx is a challenge. Objective The purpose of this study is to introduce to the literature the use of “bi-cortical” periarticular K-Wire Fixation for displaced unstable transverse extra-articular fractures of the base of the proximal phalanx of the fingers. Patients and Methods This is a retrospective study of 30 patients with such fractures treated by the author over the last 10 years. Demographic data were collected and surgical complications were documented. The outcome was considered excellent, good, fair and poor if the total active motion of the finger was >260o, 250o-259o, 210o - 249o, and Results The worst outcome was seen in an elderly patient who sustained multiple fractures and concurrent flexor tendon injury. The remaining 29 patients were relatively young (mean age of 29 years, range = 19 – 42 years) and sustained an isolated single fracture from a fall or a fight. Out of these 29 patients, the outcome was excellent in 27 patients and good in the remaining 2 patients. Conclusions The “bi-cortical” periarticular k-Wire Fixation is best suited for transverse extra-articular fractures of the base of the proximal phalanx. The Wire avoids all joints and hence, early post-operative mobilization is feasible. The technique is simple and obtains a favorable outcome in most patients. Type of study/level of evidence Therapeutic IV
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closed reduction and percutaneous periarticular single k Wire Fixation for displaced unstable transverse fractures of the proximal phalanx in elderly osteoporotic women a case series of five patients
International Journal of Surgery Case Reports, 2017Co-Authors: Abdulaziz Alazzam, Mohammad M AlqattanAbstract:Abstract Introduction A literature review did not reveal any study investigating the results of surgical management of fractures of the proximal phalanx in elderly osteoporotic women. We present a case series of five patients. Patients and methods Five consecutive cases with seven fractures of the shaft/base of the proximal phalanx were retrospectively reviewed. The mean age of the study group was 72.4 years (range, 70–76 years). All patients were on treatment for osteoporosis at the time of injury. All patients were treated with closed reduction and percutaneous “periarticular” single K-Wire Fixation followed by immediate active mobilization of all joints. Results Two minor complications were seen: superficial pin tract infection in one case; and slight fracture displacement after K-Wire removal resulting in malunion in the other case. After a mean follow-up of 4 months, the total active motion was considered excellent in 5 fingers and good in 2 fingers. Conclusion We demonstrate a favorable outcome following closed reduction and percutaneous “periarticular” single K-Wire Fixation for displaced unstable transverse fractures of the proximal phalanx in elderly osteoporotic women.
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salter harris type iv fracture of the proximal phalanx of the thumb with rotation of the epiphysis outcome 10 years following open reduction and k Wire Fixation
International Journal of Surgery Case Reports, 2017Co-Authors: Mohammad M AlqattanAbstract:Abstract Introduction Salter-Harris type IV fracture of the proximal phalanx with 90° rotation of the epiphysis is very rare. We report on a case of Salter-Harris type IV fracture of the proximal phalanx of the thumb with rotation of the epiphysis and document the outcome 10 years after surgery. Presentation of case A 5-year old boy presented with Salter-Harris type IV fracture of the thumb with 90° rotation of the epiphysis. Open reduction and K-Wire Fixation was done. Ten years later, the injured thumb was smaller in width when compared to the contralateral thumb, although there was no length discrepancy. Clinically, there was full range of motion. Radiologically, the physis was still open but there were minor irregularities at the adjacent metaphyseal base and epiphysis. The diaphysis of the injured proximal phalanx had a constricted appearance when compared to the contralateral normal side. Discussion After an extensive literature review, we found one reported case which was similar to our case and had long term assessment. At skeletal maturity, there was complete remodeling and full range of motion of the digit with no shortening. The X-ray showed a constricted diaphysis of the proximal phalanx with an identical appearance to our case. Conclusion We present a rare case of Salter-Harris type IV fracture of the proximal phalanx of the thumb with rotation of the epiphysis. Long term outcome was satisfactory but there was diaphyseal constriction leading to a narrower thumb.
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marked resorption of the thumb proximal phalanx following open reduction and k Wire Fixation of a phalangeal neck fracture in a child case report
Journal of Hand Surgery (European Volume), 2015Co-Authors: Mohammad M AlqattanAbstract:We report on a child with nonunion of a phalangeal neck fracture of the thumb following open reduction and K-Wire Fixation. There was progressive resorption of the proximal but not the distal fracture fragment. Successful reconstruction was obtained using a non-vascularized iliac crest bone graft.
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displaced unstable transverse fractures of the shaft of the proximal phalanx of the fingers in industrial workers reduction and k Wire Fixation leaving the metacarpophalangeal and proximal interphalangeal joints free
Journal of Hand Surgery (European Volume), 2011Co-Authors: Mohammad M AlqattanAbstract:A series of 35 adult male industrial workers with displaced unstable transverse fractures of the shaft of the proximal phalanx of the fingers were treated with reduction and K-Wire Fixation leaving the metacarpophalangeal and interphalangeal joints free to move immediately after surgery. At final follow-up, the total active motion score of the injured finger was graded as excellent, good, fair, or poor if it was greater than 240°, 220-240°, 180-219°, or less than 180°, respectively. Complications were also documented. The results were compared with our previously published series of these fractures treated with two other techniques: percutaneous K-Wires immobilizing the metacarpophalangeal joint and open reduction and interosseous loop Wire Fixation. The final TAM scores in the current study were excellent in 43%, good in 29%, fair in 14% and poor in 14%. Four out of the 35 patients (11%) had minor pin tract infection. These results were significantly better than the results following percutaneous K-Wire Fixation immobilizing the metacarpophalangeal joint indicating that immediate mobilization of all joints has a significant effect on the outcome.
A Aladin - One of the best experts on this subject based on the ideXlab platform.
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dorsal fracture dislocation of the proximal interphalangeal joint a comparative study of percutaneous kirschner Wire Fixation versus open reduction and internal Fixation
Journal of Hand Surgery (European Volume), 2005Co-Authors: A AladinAbstract:Nineteen patients with a dorsal fracture–dislocation of the proximal interphalangeal joint of a finger were treated with either closed reduction and transarticular Kirschner Wire Fixation (eight cases) or open reduction and internal Fixation, using either one or two lag screws (six cases) or a cerclage Wire (five cases). At a mean follow-up of 7 (range 6–9) years, most patients reported satisfactory finger function, even though some of the injuries healed with proximal interphalangeal joint incongruency (seven cases) or subluxation (four cases). Those treated by open reduction complained of more “loss of feeling” in the affected finger and those specifically treated by cerclage Wire Fixation reported more cold intolerance and had a significantly larger fixed flexion deformity (median, 30°: range 18–38°) and a smaller arc of motion (median, 48°: range 45–60°) at the proximal interphalangeal joint, despite having the best radiological outcomes. Closed reduction and transarticular Kirschner Wire Fixation produced satisfactory results, with none of the eight patients experiencing significant persistent symptoms despite a reduced arc of proximal interphalangeal joint flexion (median=75°; range 60–108°). The results of this relatively simple treatment appear at least as satisfactory as those obtained by the two techniques of open reduction and internal Fixation, both of which were technically demanding.
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dorsal fracture dislocation of the proximal interphalangeal joint a comparative study of percutaneous kirschner Wire Fixation versus open reduction and internal Fixation
Journal of Hand Surgery (European Volume), 2005Co-Authors: A AladinAbstract:Nineteen patients with a dorsal fracture-dislocation of the proximal interphalangeal joint of a finger were treated with either closed reduction and transarticular Kirschner Wire Fixation (eight cases) or open reduction and internal Fixation, using either one or two lag screws (six cases) or a cerclage Wire (five cases). At a mean follow-up of 7 (range 6-9) years, most patients reported satisfactory finger function, even though some of the injuries healed with proximal interphalangeal joint incongruency (seven cases) or subluxation (four cases). Those treated by open reduction complained of more "loss of feeling" in the affected finger and those specifically treated by cerclage Wire Fixation reported more cold intolerance and had a significantly larger fixed flexion deformity (median, 30 degrees : range 18-38 degrees ) and a smaller arc of motion (median, 48 degrees : range 45-60 degrees ) at the proximal interphalangeal joint, despite having the best radiological outcomes. Closed reduction and transarticular Kirschner Wire Fixation produced satisfactory results, with none of the eight patients experiencing significant persistent symptoms despite a reduced arc of proximal interphalangeal joint flexion (median=75 degrees ; range 60-108 degrees ). The results of this relatively simple treatment appear at least as satisfactory as those obtained by the two techniques of open reduction and internal Fixation, both of which were technically demanding.
M M Alqattan - One of the best experts on this subject based on the ideXlab platform.
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open reduction and cerclage Wire Fixation for long oblique spiral fractures of the proximal phalanx of the fingers
Journal of Hand Surgery (European Volume), 2008Co-Authors: M M Alqattan, K AlzahraniAbstract:Fifteen cases of long oblique/spiral fractures of the shaft of the proximal phalanx of the fingers treated by open reduction, cerclage Wire Fixation and immediate postoperative mobilisation were studied prospectively. Twelve patients presented early (within 24 hour of injury) and the remaining three cases were treated initially elsewhere by closed reduction and percutaneous oblique K-Wire Fixation with failure of the Fixation. The latter three patients presented to our clinic late (10-14 days after injury). Following internal Fixation with cerclage Wires, no cases of infection, complex regional pain syndrome (CRPS) Type 1, fracture re-displacement, Wire migration or extrusion were noted. One patient complained of a palpable Wire which was removed 4 months after surgery. All fractures united and all patients returned to work at a mean of 8 (range 7-11) weeks after surgery. Twelve patients obtained a full range of motion (total active motion-TAM = 260 degrees ) and the remaining three patients had a mild (5-15 degrees ) flexion contracture of the proximal interphalangeal joint. Cerclage Wire Fixation is an acceptable technique of Fixation for these fractures.
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long oblique spiral mid shaft metacarpal fractures of the fingers treatment with cerclage Wire Fixation and immediate post operative finger mobilisation in a wrist splint
Journal of Hand Surgery (European Volume), 2007Co-Authors: M M Alqattan, A AllazzamAbstract:The cerclage Wire technique of internal Fixation for displaced long oblique/spiral metacarpal shaft fractures has not gained popularity for two reasons: many believe that Wire migration is a real possibility and that the Fixation technique is not rigid enough to allow immediate postoperative finger mobilisation. In this report, the authors review the results of 19 cases of long oblique/spiral mid-shaft metacarpal shaft fractures of the fingers treated by cerclage Wires and immediate postoperative mobilisation of all finger joints. The study included 17 men and two women with a mean age of 35 (range 18–45) years. After a mean follow-up of 8 weeks, all patients regained full range of motion of the fingers and no complications were noted. It is concluded that cerclage Wire Fixation of long oblique/spiral mid-shaft metacarpal fractures requires neither scoring of the bone (a technique recommended by other authors to prevent Wire migration) nor finger immobilisation and that the technique consistently achieves good functional results.
Young Ho Lee - One of the best experts on this subject based on the ideXlab platform.
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prospective multicenter trial of modified retrograde percutaneous intramedullary kirschner Wire Fixation for displaced metacarpal neck and shaft fractures
Plastic and Reconstructive Surgery, 2012Co-Authors: Seung Hwan Rhee, Sang Ki Lee, Sang Lim Lee, Jihyeung Kim, Goo Hyun Baek, Young Ho LeeAbstract:Background The purpose of this prospective multicenter study was to assess the clinical and radiographic outcome of a newly devised technique of retrograde intramedullary Fixation with multiple Kirschner Wires in metacarpal neck and shaft fractures. Methods Between May of 2002 and June of 2007, a total of 121 metacarpal fractures in 105 patients that were treated with the authors' modified intramedullary Kirschner Wire Fixation technique were included in this study. The average follow-up period was 10 months. The surgical outcome was assessed by clinical and radiographic data. Results The average range of motion in the metacarpophalangeal joint of the injured side was not significantly different from that of the uninjured side. There was no case of residual rotational deformity postoperatively, and the average Disabilities of the Arm, Shoulder and Hand questionnaire score was 8.5 (range, 0 to 41). Average dorsal apex angulation and average shortening were reduced significantly from 39.0 degrees and 3.1 mm, to 9.7 degrees and 0.0 mm, respectively, in neck fractures; and from 29.5 degrees and 3.0 mm, to 7.0 degrees and -0.1 mm in shaft fractures, respectively. Average time to union was 5.6 weeks, and there were no cases of nonunion. Conclusion Modified retrograde intramedullary Fixation with multiple Kirschner Wires is a straightforward and reliable technique that successfully resulted in good functional and cosmetic results in addition to excellent bone healing. Clinical question/level of evidence Therapeutic, IV.
K Alzahrani - One of the best experts on this subject based on the ideXlab platform.
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open reduction and cerclage Wire Fixation for long oblique spiral fractures of the proximal phalanx of the fingers
Journal of Hand Surgery (European Volume), 2008Co-Authors: M M Alqattan, K AlzahraniAbstract:Fifteen cases of long oblique/spiral fractures of the shaft of the proximal phalanx of the fingers treated by open reduction, cerclage Wire Fixation and immediate postoperative mobilisation were studied prospectively. Twelve patients presented early (within 24 hour of injury) and the remaining three cases were treated initially elsewhere by closed reduction and percutaneous oblique K-Wire Fixation with failure of the Fixation. The latter three patients presented to our clinic late (10-14 days after injury). Following internal Fixation with cerclage Wires, no cases of infection, complex regional pain syndrome (CRPS) Type 1, fracture re-displacement, Wire migration or extrusion were noted. One patient complained of a palpable Wire which was removed 4 months after surgery. All fractures united and all patients returned to work at a mean of 8 (range 7-11) weeks after surgery. Twelve patients obtained a full range of motion (total active motion-TAM = 260 degrees ) and the remaining three patients had a mild (5-15 degrees ) flexion contracture of the proximal interphalangeal joint. Cerclage Wire Fixation is an acceptable technique of Fixation for these fractures.
