Hand Trauma

Remodeling Potential of Phalangeal Distal Condylar Malunions in Children

Puckett BN, Gaston RG, Peljovich AE, et al (Childrens Healthcare of Atlanta, GA; Atlanta Med Ctr Orthopaedic Residency Program, GA; Hand and Upper Extremity Ctr of Georgia, Atlanta; et al) J Hand Surg 37A:34-41, 2012^§

Abstract

Purpose

Distal condylar phalangeal (DCP) fractures in children are uncommon, but their periarticular location makes them problematic. Malunions are particularly difficult to treat. These fractures are generally thought to have a poor remodeling potential because their location is far from the phalangeal physis. We present 8 cases of DCP malunion in children with a mean 5-year follow-up demonstrating consistent remodeling.

Methods

In this study, DCP fractures were defined as those occurring at or distal to the collateral ligament recess of the proximal or middle phalanx in skeletally immature patients. Radiographic parameters examined at the time of established malunion and at final follow-up included coronal and sagittal plane deformity and translational malalignment of the distal fragment in relation to the proximal shaft. Range of motion was measured, and a brief questionnaire was implemented to establish patient satisfaction.

Results

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