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Case Report
 
A novel method of treating isolated unicondylar fracture of the head of the proximal phalanx: A case report
Aysha Rajeev1, John Harrison2
1FRCS, Associate Specialist,Trauma and Orthopaedics,Queen Elizabeth Hospital, Gateshead, UK.
2FRCS, Consultant, Trauma and Orthopaedics,Queen Elizabeth Hospital, Gateshead, UK.

doi:10.5348/ijcri-2013-01-256-CR-10

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How to cite this article:
Rajeev A, Harrison J. A novel method of treating isolated unicondylar fracture of the head of the proximal phalanx: A case report. International Journal of Case Reports and Images 2013;4(1):41–45.


Abstract
Introduction: The phalangeal fractures are common hand injuries. The unicondylar fractures of proximal phalanx are unique. They need prompt and accurate treatment to have a good functional outcome. We present a technique for managing a volar displaced (type 4) unicondylar fracture of the proximal phalanx. This provides accurate reduction and stabilization until fracture union, with minimal soft tissue tethering to allow early movement.
Case Report: A 26-years-old male sustained an injury to the right index finger while playing cricket. He attended fracture clinic complaining of pain and difficulty in moving the proximal interphalangeal (PIP) joint of the index finger. The X-ray showed a unicondylar fracture of the proximal phalanx in the coronal plane, with a displaced volar fragment. The patient was treated with open reduction and internal fixation with a single Kirschner wire (K-wire) passed from volar to dorsal aspect through the fragment. The patient commenced hand physiotherapy straight away and regained full range of movements.
Conclusion: We report the technique of fixing the displaced unicondylar fractures of the proximal phalanx using single K-wire passed from the volar to dorsal aspect after open reduction of the fragment through a volar approach. This technique will allow early mobilization with very minimal soft tissue dissection thus preventing stiffness.

Keywords: Unicondylar, Proximal phalanx, Type 4 fracture


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Author Contributions
Aysha Rajeev – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
John Harrison – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
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The corresponding author is the guarantor of submission.
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Conflict of interest
Authors declare no conflict of interest.
Copyright
© Aysha Rajeev et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)