Operative Treatment for Dorsal Lip Fracture of the Base of the Middle Phalanx

Abstract

Purpose: To evaluate the clinical and radiological results of operative treatment for dorsal lip fracture of the base of the middle phalanx. Materials and Methods: From 1992 to 2003 we experienced 9 cases of dorsal lip fracture of the middle phalangeal base that were treated surgically. Spinal needle fixation was used in cases with comminution. Miniscrew fixation was performed in cases with a fragment larger than half of the articular surface. The pull-out technique was performed only in the cases with a fragment without comminution smaller than half of the articular surface. Bone union was evaluated using roentgenograms and clinical evaluations were done using Steel’s scoring method. Results: The average follow up after operation was 12.3 months. Cases showed union at an average of 7 weeks postoperatively. Two cases achieved excellent results, six cases good, and one case achieved a fair result; mean proximal interphalangeal joint flexion was 100 degrees (range 90-106). Extension deficit of 5 degrees was noted in 2 fingers. Conclusion: The pull-out technique, miniscrew fixation, and spinal needle fixation can produce a good clinical and radiological outcome in the treatment of dorsal lip fracture of the base of the middle phalanx.