Your browser doesn't support javascript.
loading
Surgical Treatment of Pediatric Intra-Articular Proximal Phalangeal Head Fracture of the Big Toe
Journal of the Korean Fracture Society ; : 9-15, 2020.
Article in Korean | WPRIM | ID: wpr-811286
ABSTRACT

PURPOSE:

Pediatric intra-articularproximal phalangeal head fractures of the big toe are very rare and few studies on this have been published. The purpose of this study is to present the diagnostic approach and surgical management of these extremely rare fractures, which might be easily underestimated or misdiagnosed.MATERIALS AND

METHODS:

The study retrospectively reviewed all the patients who were diagnosed as intra-articular proximal phalangeal head fracture of the big toe and who underwent surgical intervention in our institution. The size of the bony fragment and hallux valgus interphalangeus angle were measured on the preoperative X-rays. The size and rotation of the osteochondral fragment, the presence of avascular necrosis, ligamentous injury and soft tissue entrapment were assessed on the preoperative magnetic resonance images (MRIs). The radiologic and functional evaluation were performed at 1 year postoperatively.

RESULTS:

The average size of the bony fragments measured on the X-rays was 4.1 mm in width and 2.3 mm in length. Two cases showed hallux valgus interphalangeus. Preoperative MRI was performed in four cases and the average size of any osteochondral lesion was 5.3 mm in width, 3.9 mm in length, and 4.7 mm in height. Rotation of the osteochondral fragment was observed in one patient, and soft tissue entrapment was noted in two patients. Postoperatively, successful bony union was achieved in all the patients and the average time to union was 74.4 days.

CONCLUSION:

Intra-articular proximal phalangeal head fractures of the big toe are very rare and often neglected due to incomplete ossification in the pediatric population. It is important to suspect the presence of this intra-articular fracture and to appropriately implement further evaluation. Nonunion of chronic cases as well as acute fractures can be successfully treated through open reduction and internal fixation using multiple K-wires.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Magnetic Resonance Imaging / Hallux / Hallux Valgus / Retrospective Studies / Intra-Articular Fractures / Head / Ligaments / Necrosis Type of study: Observational study Limits: Humans Language: Korean Journal: Journal of the Korean Fracture Society Year: 2020 Type: Article

Similar

MEDLINE

...
LILACS

LIS

Full text: Available Index: WPRIM (Western Pacific) Main subject: Magnetic Resonance Imaging / Hallux / Hallux Valgus / Retrospective Studies / Intra-Articular Fractures / Head / Ligaments / Necrosis Type of study: Observational study Limits: Humans Language: Korean Journal: Journal of the Korean Fracture Society Year: 2020 Type: Article