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Results of vertical figure-of-eight tension band suture for finger nail disruptions with fractures of distal phalanx.

Memon FW - Indian J Orthop (2012)

Bottom Line: We also evaluated our results based on visual analogue scale for pain and range of motion of distal interphalangeal joint.Two sutures had to be revised due to over tensioning and subsequent vascular compromise within minutes of repair; however, this did not affect the final outcome.This technique is simple, secure, and easily reproducible.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, India.

ABSTRACT

Background: Fingertip injuries involve varying degree of fractures of the distal phalanx and nail bed or nail plate disruptions. The treatment modalities recommended for these injuries include fracture fixation with K-wire and meticulous repair of nail bed after nail removal and later repositioning of nail or stent substitute into the nail fold by various methods. This study was undertaken to evaluate the functional outcome of vertical figure-of-eight tension band suture for finger nail disruptions with fractures of distal phalanx.

Materials and methods: A series of 40 patients aged between 4 and 58 years, with 43 fingernail disruptions and fracture of distal phalanges, were treated with vertical figure-of-eight tension band sutures without formal fixation of fracture fragments and the results were reviewed. In this method, the injuries were treated by thoroughly cleaning the wound, reducing the fracture fragments, anatomical replacement of nail plate, and securing it by vertical figure-of-eight tension band suture.

Results: All patients were followed up for a minimum of 3 months. The clinical evaluation of the patients was based on radiological fracture union and painless pinch to determine fingertip stability. Every single fracture united and every fingertip was clinically stable at the time of final followup. We also evaluated our results based on visual analogue scale for pain and range of motion of distal interphalangeal joint. Two sutures had to be revised due to over tensioning and subsequent vascular compromise within minutes of repair; however, this did not affect the final outcome.

Conclusion: This technique is simple, secure, and easily reproducible. It neither requires formal repair of injured nail bed structures nor fixation of distal phalangeal fracture and results in uncomplicated reformation of nail plate and uneventful healing of distal phalangeal fractures.

No MeSH data available.


Related in: MedlinePlus

Diagrammatic illustration of fingertip and nail anatomy
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Figure 1: Diagrammatic illustration of fingertip and nail anatomy

Mentions: The germinal matrix of the nail is the tissue that is responsible for the production of the cells that become nail plate1 (the actual nail). The sterile matrix lies beneath the nail plate.1 Eponychium is the small band of epithelium that extends from the posterior nail wall up to the base of the nail. The hyponychium is the epithelium located beneath the nail at the junction between its free edge and the skin of the fingertip. Nail plate or the body of the nail is the actual nail between the lateral and the medial nail folds [Figure 1].


Results of vertical figure-of-eight tension band suture for finger nail disruptions with fractures of distal phalanx.

Memon FW - Indian J Orthop (2012)

Diagrammatic illustration of fingertip and nail anatomy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3377148&req=5

Figure 1: Diagrammatic illustration of fingertip and nail anatomy
Mentions: The germinal matrix of the nail is the tissue that is responsible for the production of the cells that become nail plate1 (the actual nail). The sterile matrix lies beneath the nail plate.1 Eponychium is the small band of epithelium that extends from the posterior nail wall up to the base of the nail. The hyponychium is the epithelium located beneath the nail at the junction between its free edge and the skin of the fingertip. Nail plate or the body of the nail is the actual nail between the lateral and the medial nail folds [Figure 1].

Bottom Line: We also evaluated our results based on visual analogue scale for pain and range of motion of distal interphalangeal joint.Two sutures had to be revised due to over tensioning and subsequent vascular compromise within minutes of repair; however, this did not affect the final outcome.This technique is simple, secure, and easily reproducible.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, India.

ABSTRACT

Background: Fingertip injuries involve varying degree of fractures of the distal phalanx and nail bed or nail plate disruptions. The treatment modalities recommended for these injuries include fracture fixation with K-wire and meticulous repair of nail bed after nail removal and later repositioning of nail or stent substitute into the nail fold by various methods. This study was undertaken to evaluate the functional outcome of vertical figure-of-eight tension band suture for finger nail disruptions with fractures of distal phalanx.

Materials and methods: A series of 40 patients aged between 4 and 58 years, with 43 fingernail disruptions and fracture of distal phalanges, were treated with vertical figure-of-eight tension band sutures without formal fixation of fracture fragments and the results were reviewed. In this method, the injuries were treated by thoroughly cleaning the wound, reducing the fracture fragments, anatomical replacement of nail plate, and securing it by vertical figure-of-eight tension band suture.

Results: All patients were followed up for a minimum of 3 months. The clinical evaluation of the patients was based on radiological fracture union and painless pinch to determine fingertip stability. Every single fracture united and every fingertip was clinically stable at the time of final followup. We also evaluated our results based on visual analogue scale for pain and range of motion of distal interphalangeal joint. Two sutures had to be revised due to over tensioning and subsequent vascular compromise within minutes of repair; however, this did not affect the final outcome.

Conclusion: This technique is simple, secure, and easily reproducible. It neither requires formal repair of injured nail bed structures nor fixation of distal phalangeal fracture and results in uncomplicated reformation of nail plate and uneventful healing of distal phalangeal fractures.

No MeSH data available.


Related in: MedlinePlus