Abstract

Toe phalanx fractures are prevalent worldwide. The proximal phalanx of the hallux requires different treatment from the other four lateral phalanges. Poor positioning of rotation and angulation is not acceptable for this bone, since it can result in significant functional deficit. Indications for surgical treatment are: joint fractures with deviations greater than 2 mm, metadiaphyseal fractures with rotational and/or angular deviation, open fractures and unstable fractures. The classic medial approach in surgical treatment involves some high-risk neurovascular structures and does not allow the correct positioning of osteosynthesis systems in some cases. The aim of this study is to present an option for the surgical treatment of deviated and unstable supraintercondylar fractures of the proximal phalanx of the hallux by the dorsolateral approach, with a traction screw through the plate and a lateral neutralization plate. Level of Evidence V; Therapeutic Study; Expert Opinion.

Highlights

  • Phalanx fractures of the toes are common, representing 3.6 to 8% of lower extremity injuries[1]

  • The aim of this study is to present an option for the surgical treatment of deviated and unstable supraintercondylar fractures of the proximal phalanx of the hallux by the dorsolateral approach, with a traction screw through the plate and a lateral neutralization plate

  • The aim of this study is to present an option for the surgical treatment of deviated and unstable supraintercondylar fractures of the proximal phalanx of the hallux, through the dorsolateral approach

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Summary

Supraintercondylar fracture of the proximal phalanx of the hallux

Alexandre Leme Godoy-Santos1,2 , André Wajnsztejn , Mercedes Elizabeth Tacuri Juncay , Cesar de Cesar Netto , Germán Matías Joannas , Vincenzo Giordano. 1. Lab. Prof Manlio Mario Marco Napoli, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. 2. Hospital Israelita Albert Einstein, São Paulo, SP, Brazil. 3. Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa, United States. Nova Monteiro Orthopedics and Traumatology Service, Hospital Municipal Miguel Couto, Rio de Janeiro, RJ, Brazil

Introduction
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