Malunion of fractures of the proximal phalangeal neck in children.

We report three cases of malunion after fractures of the proximal phalangeal neck in children. A 12-year-old boy and a 7-year-old girl had malunited fractures with dorsal and ulnar deviation of their fingers. Several years later remodeling had been achieved well for dorsal deviation but little for the ulnar deviation in each case. A 10-year-old boy had a similar malunited fracture with dorsal and ulnar deviation of his finger. The proximal bony spike, which protruded to the volar side, collided with the middle phalanx during flexion of the proximal interphalangeal (PIP) joint, so we shaved it. One year after operation, flexion of the PIP joint had improved. In cases of these malunited fractures in children, remodeling is considered possible for dorsal deviation but difficult for ulnar deviation. Surgical shaving of the protruding bone should be considered.