Experience in the use of transosseous compression-distraction osteosynthesis with a rod apparatus for open fractures of the proximal phalanx of the finger, complicated by tendon rupture

Authors:

Yamshikov Oleg Nikolaevich — Grand PhD in Medical Sciences (Dr. Med. Sci.), Professor, Head of the Department of Hospital Surgery with a Traumatology Course, Medical Institute, Tambov State University named after GR Derzhavin, 33 Internatsional’naya Street, 392000 Tambov, Russian Federation; chief physician of the City Clinical Hospital of Kotovsk, 24 Pionerskaya Street, 393190 Kotovsk, Russian Federation; e-mail: travma68@mail.ru; https://orcid.org/0000-0001-6825-7599.

Emelyanov Sergey Aleksandrovich — PhD in Medical Sciences (Cand. Med. Sci.), Associate Professor of the Department of Hospital Surgery with a Course of Traumatology, Medical Institute, Tambov State University named after GR Derzhavin, 33 Internatsional’naya Street, 392000 Tambov, Russian Federation; deputy chief physician of the City Clinical Hospital of Kotovsk, 24 Pionerskaya Street, 393190 Kotovsk, Russian Federation; e-mail: cep_a@mail.ru; https://orcid.org/0000-0001-6825-7599.

Petrukhin Anton Nikolaevich — senior lecturer of the Department of Hospital Surgery with a Course of Traumatology, Medical Institute, Tambov State University named after GR Derzhavin, 33 Internatsional’naya Street, 392000 Tambov, Russian Federation; Head of the Department of Traumatology of the City Clinical Hospital of Kotovsk, 24 Pionerskaya Street, 393190 Kotovsk, Russian Federation; e-mail: chuma0106@rambler.ru; https://orcid.org/0000-0003-2586-3489.

Chumakov Roman Vyacheslavovich — resident in the specialty Radiology of the Department of Hospital Surgery with a Course of Traumatology, Medical Institute, Tambov State University named after GR Derzhavin, 33 Internatsional’naya Street, 392000 Tambov, Russian Federation; e-mail: roman68881@yandex.ru; https://orcid.org/0000-0002-4501-4022.

Pavlova Ksenia Aleksandrovna — resident in the specialty Anesthesiology of the Department of Hospital Surgery with a Course of Traumatology, Medical Institute, Tambov State University named after GR Derzhavin, 33 Internatsional’naya Street, 392000 Tambov, Russian Federation; e-mail: ksenia.nickolaewa@yandex.ru; https://orcid.org/0000-0003-1931-0706.

Annotation:

Introduction. Injuries to the hand account for 30% to 80% of all skeletal pathologies in traumatology practice. The frequency of injuries is associated with the complex function of the hand in a person’s social life and professional activity. Open hand fractures rank second among open hand injuries. With open fractures, tendons, neurovascular bundles, ligaments are often damaged, and there are skin defects. Therefore, this type of fracture requires urgent surgical intervention in order to maintain the functionality of the hand and reduce the number of complications.

Aim. Demonstrate the successful experience of treating a patient with an open fracture of the proximal phalanx of the third finger of the left hand with displacement of fragments, complicated by tendon rupture.

Materials and methods. Description of a clinical case and brief analysis of the literature on this topic. The experience of treating a fracture of the proximal phalanx of the left hand using transosseous compression-distraction osteosynthesis is presented. The effectiveness of treatment was assessed based on X-ray data, as well as by assessing the function and range of motion of the third finger of the left hand. A search was also conducted in the open electronic scientific databases PubMed of the US National Electronic Medical Library and the databases of the Russian scientific electronic library elibrary using keywords and phrases: femur fracture, proximal part, surgical treatment, transosseous compression-distraction osteosynthesis.

Results. Transosseous osteosynthesis of the fracture of the proximal phalanx of the third finger of the left hand was performed, as well as suture of the extensor tendon. On the fourth day after surgery, the patient was discharged for outpatient treatment by a traumatologist at his place of residence in satisfactory condition. The wound and sutures have no signs of inflammation; the skin in the area of the third interdigital space is pale. Pain, tactile and temperature sensitivity is preserved, blood supply is not impaired.

Discussion. Analyzing the results of surgical treatment in the described clinical case, we can conclude that the method of transosseous compression-distraction osteosynthesis is highly effective for open fractures of the phalanges of the fingers with displacement of fragments, including those complicated by tendon rupture.

Conclusion. In order for the treatment of a fracture of the phalanges of the fingers to be successful, it is necessary to perform an accurate anatomical comparison of the fragments, ensure complete immobilization of the damaged area, followed by complex therapy. Our experience allows us to believe that treatment with transosseous compressiondistraction osteosynthesis is effective for severe injuries of the hand bones and reduces the number of complications, such as nonunion or the occurrence of false joints, and also significantly reduces the period of disability.

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