Re: 'inside screw' wire-frame for internal fixation of intraarticular fracture.

摘要

A 38 year-old male manual worker presented with a comminuted fracture of the base of the proximal phalanx of the thumb (Fig 1A). Fracture reduction was achieved by axial traction. An attempt at osteo-synthesis with K-wires resulted in unstable fixation and immobilisation with an external frxator would have involved the metacarpophalangeal joint, and so was not used. Finally, alignment of the joint surface was maintained with a transverse cannulated screw and the metaphyseal fracture was stabilised with a box loop wire passed around the fracture. Distally, the wire of the loop passed through the bone of the phalangeal shaft, while, proximally, it passed through the cannula-tion of the screw (Fig 1B). The fixation was sufficiently stable to allow early mobilisation of the thumb. At 8 months, the patient had regained a painless and full range of motion of the adjacent metacarpophalangeal joint, although interphalangeal joint flexion was slightly reduced.