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Pediatric Phalangeal Base and Shaft Fractures

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Pediatric and Adult Hand Fractures

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Abstract

Pediatric phalangeal base and shaft fractures of the proximal and middle phalanx are common injuries and can usually be treated with nonoperative management with or without a closed reduction and immobilization. The physical examination is vital to the treatment pathway, as any rotational deformity or substantial deviation is unacceptable and may require percutaneous pinning if the initial reduction does not correct the deformity. Deformities near the physis and in the plane of motion of the joint have a higher propensity to correct with remodeling, but the metacarpophalangeal (MCP) joint is more forgiving and is generally more stable than the proximal interphalangeal (PIP) joint. When treating patients nonoperatively, patients should be closely clinically and radiographically followed to ensure a loss of reduction has not occurred and no rotational deformities have developed. In patients requiring operative intervention, an open reduction should be performed, to dislodge any interposed soft tissue if present, for irreducible fractures whereas a closed reduction and percutaneous pinning is the most widely used treatment for fractures amenable to closed reduction techniques. Stiffness is the most common complication, and some patients may benefit from formal therapy to improve their motion.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, University of Maryland School of Medicine, Baltimore, MD, USA

    Tristan B. Weir, Catherine C. May & Joshua M. Abzug

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  1. Tristan B. Weir
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  2. Catherine C. May
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  3. Joshua M. Abzug
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Correspondence to Joshua M. Abzug .

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Editors and Affiliations

  1. Department of Orthopedic Surgery, University of Maryland School of Medicine, Baltimore, MD, USA

    Joshua M. Abzug

  2. Atrium Health Carolinas Medical Center, Charlotte, NC, USA

    R. Glenn Gaston

  3. Philadelphia Hand to Shoulder Center, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    A. Lee Osterman

  4. Rothman Orthopaedic Institute Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA

    Richard J. Tosti

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Weir, T.B., May, C.C., Abzug, J.M. (2023). Pediatric Phalangeal Base and Shaft Fractures. In: Abzug, J.M., Gaston, R.G., Osterman, A.L., Tosti, R.J. (eds) Pediatric and Adult Hand Fractures. Springer, Cham. https://doi.org/10.1007/978-3-031-32072-9_4

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