Clinical Examples: Pin fixation distal phalanx nonunion

Distal phalanx fractures are common, but because of good vascularity and the splinting effect of the nail plate, fracture nonunions are not common. These cases illustrate longitudinal pin fixation of delayed union of distal phalanx fractures.
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Case 1.
6 week old grossly unstable distal phalanx fracture. Fracture reduced through a midline palmar approach and stabilized with extraarticular nonparallel Kirschner wires.
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Exposure.
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The K-wires were bent to form a zone of overlap which was bonded together with thermoplastic splint material.
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Pins were removed at 5 weeks with uneventful fracture healing.
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Case 2.
3 month old grossly unstable nonunion.
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The new nail plate is visible growing deep to the original nail plate.
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The distal nail plate fragment was removed, and the fracture was stabilized with K-wires as in case 1.
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Two months following hardware removal.
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