cad a22 4500 555259331 20200206043959.0 cr unu---uuuuu 190205e20191001xx s 000 0 eng 10.5167/uzh-161560 doi 10.1097/BPO.0000000000001335 doi (ZORA)oai:www.zora.uzh.ch:161560 610 ddc 30628978 pmid Vonlanthen Janine Nonarticular Base and Shaft Fractures of Children's Fingers: Are Follow-up X-rays Needed? Retrospective Study of Conservatively Treated Proximal and Middle Phalangeal Fractures [Elektronische Daten] [Janine Vonlanthen, Daniel M Weber, Michelle Seiler] openAccess eu-repo BACKGROUND Phalangeal fractures of the hand are common in children, and most extra-articular fractures can be treated with nonoperative management. Minimally or nondisplaced fractures may simply be immobilized, whereas displaced fractures need closed reduction before immobilization. Although few of these fractures displace secondarily, most schemes currently recommend follow-up x-rays after initial diagnosis. Our primary objective was to identify subgroups of finger fractures that are stable, thus requiring no radiographic monitoring. METHODS This study was designed as a retrospective, single-center analysis of conservatively treated pediatric finger fractures of the proximal and middle phalanges. We included patients up to 16 years with base or shaft fractures of the index to little fingers who underwent nonoperative treatment and standardized follow-up controls in our pediatric hand surgery outpatients' clinic between 2010 and 2016. Fracture angular deformity in x-rays taken at diagnosis and after 1 and 3 weeks were reassessed blinded, and a statistical analysis was conducted to identify fracture types that are prone to secondary angular deformity. RESULTS A total of 478 patients were eligible; 113 were lost due to missing final radiographic controls. Overall, 365 patients were analyzed; they had a mean age of 9.7 years (range, 1 to 16), and 33.4% required a primary closed reduction. A secondary angular deformity occurred in 2.2% (8/365) of all finger fractures. No secondary angulation occurred in primary minimally and nondisplaced fractures, but 6.6% (8/122) of the reduced fractures showed a subsequent loss of reduction. CONCLUSIONS Minimally angulated (<10 degrees) and nondisplaced metaphyseal and diaphyseal fractures of proximal and middle phalanges of the index to little fingers are stable and therefore do not need radiographic follow-ups. However, initially angulated fractures requiring closed reduction bear a risk of subsequent loss of reduction. Medical Clinic zora Clinic for Surgery zora Weber Daniel M. joint author Seiler Michelle joint author Journal of Pediatric Orthopaedics 39(9):e657-e660 https://www.zora.uzh.ch/id/eprint/161560/1/Nonarticular_Base_and_Shaft_Fractures_of.98596.pdf text/html WWW-Backlink auf das Repository 1 Journal Article PeerReviewed zora ZORA 856 40 https://www.zora.uzh.ch/id/eprint/161560/1/Nonarticular_Base_and_Shaft_Fractures_of.98596.pdf text/html WWW-Backlink auf das Repository ZORA 100 1- Vonlanthen Janine ZORA 700 1- Weber Daniel M. joint author ZORA 700 1- Seiler Michelle joint author ZORA 773 0- Journal of Pediatric Orthopaedics 39(9):e657-e660 BK010053 XK010053 XK010000 ZORA ZORA ZORA Journal Article openAccess