Phalangeal neck fractures in children: classification and outcome in 66 cases.

A series of 66 children with 67 phalangeal neck fractures in the hand is presented. Young children (1-3 years of age) made up 44% of the series. The mechanism of injury was entrapment of the digit in a closing door or a swing in almost all cases. Type I fractures (n = 13) were undisplaced and treatment with a splint resulted in excellent results in almost all cases. Type II fractures were defined as displaced fractures with some bone-to-bone contact. There were 47 Type II fractures and the outcome was significantly affected by the method of initial management. Fractures treated without K-wire fixation had a significantly worse outcome than those who underwent K-wire fixation. Type III fractures (n = 7) were displaced with no bone-to-bone contact. If inadequately treated, these fractures did not unite.