[Is mini-screw osteosynthesis a suitable procedure in surgical treatment of intra-articular distal phalanx fractures?].

In a retrospective clinical study, the results of operative treatment of intraarticular fractures of the distal phalanx were studied. From February 1992 to December 1998, 75 patients were treated operatively, 47 were examined. 14 patients were treated with Lengemann wire and temporary transfixation of the DIP joint, 25 patients were treated with screw fixation and in eight patients another procedure (wire suture, Kirschner wire, "Hakendraht", combination of screw and wire) was used. All patients had little or no pain. All patients had no or only little limitation in activities of daily living. Two patients after screw fixation had serious limitations. Four patients after Lengemann wire fixation had an extension lag in the DIP joint of up to 10 degrees, four patients between 11 and 20 degrees and one patient 25 degrees. 19 patients after screw fixation had an extension lag of the DIP joint of up to 10 degrees, five patients between 11 and 20 degrees and one patient of 25 degrees. Arthrosis of the DIP joint was seen in five patients after Lengemann wire fixation and in two patients after screw fixation. Screw fixation in the treatment of intraarticular fractures of the distal phalanx is a good, but demanding procedure with the potential for exact reconstruction of the joint surface, since implant removal is not necessary.