You are here

Phalanx Fracture ORIF 26735

synonyms:phalanx fracture ORIF, phalangeal fracture ORIF, finger ORIF, phalanx fixation

CRPP/ ORIF Hand Fracture CPT

CRPP/ ORIF Hand Fracture Indications

  • Displaced metacarpal and phalangeal fracture

CRPP/ ORIF Hand Fracture Contraindications

  • Medically unstable patients
  • Active infection

CRPP/ ORIF Hand Fracture Alternatives

  • Splinting / buddy tape

CRPP/ ORIF Hand Fracture Pre-op Planning

CRPP/ ORIF Hand Fracture Technique

  • Sign operative site.
  • Pre-operative antibiotics, +/- regional block.
  • General endotracheal anesthesia
  • position. All bony prominences well padded.
  • Examination under anesthesia.
  • Prep and drape in standard sterile fashion.
  • Irrigate.
  • Close in layers.

Phalangeal Shaft Fracture CRPP Technique

  • Belsky MR, J Hand Surg 1984;9Am:725
  • 0.045 (1.1mm) K-wires generally used. Consider 0.062in(1.6mm) for larger bones(metacarpal); 0.035in(0.9mm) for smaller bones (pediatric fx).
  • Closed reduction under c-arm guidance.
  • one or more intramedullary or two crossed K-wires.
  • K-wires must not cross at the fracture site.
  • K-wires are left in until fracture callus in visible on xray. Usually 3-4 weeks

CRPP/ ORIF Hand Fracture Complications

  • Loss of reduction
  • Delayed union
  • Malunion
  • Nonunion
  • Tendon adhesion / stiffness
  • Nerve or vascular injury
  • Infection
  • Painful hardware

CRPP/ ORIF Hand Fracture Follow-up care

  • Post-op /Initial: Splint. Elevation.
  • 7-10 Days: xray to ensure reduction is maintained. Continued splint, activity modifications. Immobilize as few joints as necessary. Begin ROM as soon as fixation strength with allow.
  • 6 Weeks: Remove k-wire, wean from splint use as soon as callus is visible on xray. Continue activity modifications. Agressive ROM.
  • 3 Months: Resume full activities. Assess ROM. Consider flexor/extensor tenolysis if tendon adhesions fail to improve.
  • 1Yr: assess outcomes / follow-up xrays.

CRPP/ ORIF Hand Fracture Outcomes

CRPP/ ORIF Hand Fracture Review References

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer