Clinical results of phalangeal neck fractures in children aged 3 years or younger: a case series of 37 patients.

BACKGROUND

Phalangeal neck fractures (PNFs) are predominantly observed in the pediatric population. This study aims to investigate surgical outcomes and complications of PNF in children less than 3 years of age.

METHODS

Clinical data of children diagnosed with PNF treated in our hospital from January 2012 to December 2022 were retrospectively reviewed. At final follow-up, the outcome was evaluated by a modified Al-Qattan's grading system.

RESULTS

There were 37 patients as our study population, including 22 male and 15 female patients with a mean age of 26.7 ± 2.1 months. Patients were followed up for a mean of 20 months. There were 27 PNFs with Type II fractures and ten patients were confirmed as Type III before treatment, respectively. Eight children had concurrent injuries, four of them accompanied by soft tissue injury and four of them accompanied by open fractures. Four cases occurred loss of reduction without further surgical correction. There was a significant difference in loss of reduction between PNFs of the thumbs and PNFs of other fingers (P < 0.05). According to the modified Al-Qattan's grading system, 33 patients (89.2%) had good to excellent results and 4 patients had fair to poor results.

CONCLUSION

Most PNFs in children less than 3 years old obtained satisfied results. We have recommended that single and longitudinal K-wire be used to fix PNFs. An additional oblique candlestick may be utilized to prevent loss of reduction if the thumb affected, and stability was questionable following reduction.

LEVEL OF EVIDENCE: III.