Nonunion in a fracture of the proximal phalanx of the thumb.

We describe the management of atrophic nonunion in a fracture of the proximal phalanx of the thumb in a patient who presented one and a half years after the injury. By using threaded external fixators applied across the fracture nonunion, stability for active mobilization of the metacarpophalangeal joint was achieved. The gradual distraction resulted in correction of the deformity and the shortening, as well as creation of an adequate space between the bone ends. Bone grafting and compression of the fracture with the same fixators followed. Consolidation of the fracture occurred within five months. Follow-up examination two and a half years postoperatively revealed complete remodeling of the fracture and excellent function of the hand.