DOS 2018

DOS Kongressen 2018 · 117 Phalangeal fractures of the hand Paula Engel, Elisabeth Brogren, Lars Dahlin, Henrik Søe, Stig Brorson Department of Orthopaedic Surgery, Nordsjællands Hospital; Department of Hand Surgery, Lund University; Department of Hand Surgery, Herlev and Gentofte Hospital; Department of Orthopaedic Surgery, Sjællands University Hospital Background: Phalangeal fractures are common at all ages. Although often con- sidered as minor injuries, the correct treatment can be challenging. Especially for younger doctors in emergency rooms or general practitioners, it may be difficult to decide which fractures have to be referred to an orthopaedic or hand surgeon. Purpose / Aim of Study: Our aim was to provide a simple guideline for treat- ment of the most common finger fractures and dislocations. Materials and Methods: We conducted a narrative review. Eighty- nine papers were identified from a PubMed search combining the MeSH-terms “fingers”, “fractures”, “bone” and “finger injuries”. We added the search terms “paediatric fractures”, “UCL-lesions” and “mallet finger”. We included meta-analyses, sys- tematic reviews, randomised and non-randomised clinical trials from the past 10 years. Case studies were excluded. Thirty papers were retrieved in full text and included in the review. Findings / Results: While stable, extra-articular fractures often can be treat- ed non-operatively with closed reduction and buddy-taping, surgical fixation should be considered for unstable and displaced extra-articular fractures and most intra-articular fractures. The choice of treatment should aim at early, ac- tive mobilization in order to achieve optimal functional outcome. Conclusions: Intra-articular fractures, fractures with concomitant ligament le- sions, PIP joint fracture-dislocations, open fractures and certain paediatric frac- tures can lead to stiffness and poor functional outcome and should be referred to a hand surgeon. 58.