Name of the Procedure:

Open Treatment of Phalangeal Shaft Fracture, Proximal or Middle Phalanx, Finger or Thumb (with Internal Fixation)

Summary

This surgical procedure involves accessing and repairing a broken bone in the finger or thumb. The surgery stabilizes the fracture by aligning the bone fragments and often uses internal hardware like pins, screws, or plates to hold the bones in place.

Purpose

The procedure addresses fractures in the proximal or middle sections of the finger or thumb bones (phalanges). The goal is to restore bone stability and proper alignment, ensuring proper healing, function, and minimizing the risk of long-term deformity or disability.

Indications

• Visible deformity or misalignment of the finger or thumb.
• Severe pain or inability to move the affected finger or thumb.
• X-ray confirmation of a displaced or unstable fracture.
• Prior failed non-surgical treatments (e.g., splinting or casting).

Preparation

• Fasting may be required for specific hours before surgery.
• The patient may need to adjust or stop certain medications as advised by the healthcare provider.
• Preoperative blood tests and imaging studies such as X-rays.

Procedure Description

1. The patient is given general or regional anesthesia.
2. The surgeon makes an incision over the fracture site.
3. The bone fragments are exposed and realigned to their natural position.
4. Internal fixation devices (pins, screws, plates, or wires) are used to hold the bone fragments together.
5. The incision is closed with sutures or staples.
6. The hand is bandaged, and a splint or cast may be applied to protect the repair.

Duration

The procedure typically takes 1 to 2 hours.

Setting

This procedure is performed in an operating room within a hospital or a specialized surgical center.

Personnel

• Orthopedic or hand surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses and technicians

Risks and Complications

• Infection at the surgery site
• Nerve damage or impaired finger sensation
• Blood vessel injury and potential for poor blood supply to the finger
• Stiffness or loss of motion in the finger
• Hardware complications requiring additional surgery

Benefits

• Stabilizes the fracture for proper healing.
• Restores normal alignment and function of the finger or thumb.
• Reduces pain and long-term complications.

Recovery

• Keep the hand elevated and avoid heavy lifting.
• Follow instructions for pain management, such as taking prescribed medications.
• Regular follow-up to monitor healing through X-rays and clinical examinations.
• Physiotherapy or exercises to regain strength and mobility.
• Full recovery typically takes several weeks to months.

Alternatives

• Non-surgical treatments such as splinting or casting.
• Closed reduction (resetting the bone without surgery) if the fracture is stable.
• Pros: Less invasive, reduced infection risk.
• Cons: May not provide sufficient stability for unstable fractures, with a higher risk of re-displacement.

Patient Experience

Patients may experience swelling and discomfort post-surgery. Pain is managed with medications. Mild discomfort can persist as the bone heals, but physiotherapy aids in restoring function and mobility. Pain and stiffness resolution varies, typically improving over weeks.