Bone Union Rates in Open Phalangeal Fracture of Hand

Suh, S W; Lee, S H; Oh, J G; Park, D; Kim, K S; Kim, C J

Abstract

This review was undertaken to analyze the rate of bone union according to accuracy of reduction, methods of fixation, timimg of wound closure and to determine if immediate wound closure increases the infection rate. The materials used in this study included 49 cases of open digital fractures of hand which had been treated at Ansan Hospital, Korea University, College of Medicine from January, 1988 to May, 1995. Of the 38 patients, male were 34(89.5%) and female were 4(10.5%). The average age at operation was 31.9(ranging from 18 to 56 years). On terms of sites of injury within digits, proximal phalanx injured in 18 cases, mid-phalanx16 cases, distal phalanx 20 cases. As a fixatives, K-wire was used in 36 cases(73.5%), mini-plate 8 cases(16.3%), splint immobilization in 5 cases(10.2%). Average time to bone union for K-wire fixation was 12.8 weeks, miniplate was 13.6 weeks, splint immobilization 13.2 weeks. On terms of accuracy of reduction, width of gap between fragments were measured, cases with width of gap less than 2mm were 28 cases(57.6%), cases more than 2mm were 21 cases(42.4%). Bone union periods according to the accuracy of reduction are as follows: cases with width of gap less than 2mm was 11.4 weeks, more than 2mm-15.7 weeks, apposition more than 2/3-12.6 weeks, less than 2/3-16 weeks. Degree of soft tissue injuries was classified based on modified Gustillo-Andersons classification. One case belonged to type I injury, 15 cases to type II and 33 cases to type III. Bone union periods for type I, II was 12.9 weeks in average, and 13.8 weeks for type III.