SUMMARY
Introduction. The unstable, extraarticular phalangeal fractures are usually treated surgically. However, the rate of postoperative complications is high. With conservative technique is also possible to achieve the same results but fewer complications. Our work aimed to retrospectively evaluate the functional results and complications of the phalangeal fractures treated operatively and conservatively.

Patients and methods. We evaluated all unstable, extra-articular phalangeal fractures from January 1st, 2014 – December 31st, 2019. Patients were treated conservatively or operatively with a minimum of 12 months of follow-up. There were 33 patients treated conservatively. The average age was 41.5 ± 14.4 years (min 20 – max 80). The average healing time was 4.9 ± 1 week (min 3 – max 8). In 20 cases (60.6 %) we used a cast, in 13 cases (39.4 %) thermoplastic splint. In the group of operated patients, we identified 22 patients. The average age was 40 ± 12.9 years (min 22 – max 80). In 5 cases (22.7 %) we used K- wires, in 6 cases (27.3 %) screws. In 11 cases (50 %) we used a low-profile plate and in one case was used another type of fixation (4.5 %). The average healing time was 5.2 ± 1.3 weeks (min 0 – max 8). We evaluated the final functional result of the flexion, extension after 12 months from the injury/operation. We monitored the complications in both groups.
Results. The final average total active flexion in the group of non-operated patients was 229.3 ± 19.8 (169 – 250) degrees and in the group of the operated patients 222.8 ± 19.6 (162 – 250) degrees. The average total extension deficit in the group of non-operated patients were 18.6 ± 18.8 (0 – 81) degrees, and in the group of the operated patients was 25.7 ± 19.9 (0 – 88) degrees. We did not notice any statistically notable differences between the two groups. In the group of conservatively treated patients malunion occurred in 5 cases (15.2 %) In the group of operatively treated patients malunion occurred in 6 cases (27.3 %), wound healing problems in 2 cases (9.1 %) and the infectious complication in 2 cases (9.1 %). There were more complications in the group of operated patients and were statistically significant (p = 0.02).
Conclusion. Operative treatment of unstable, extra-articular phalangeal fractures doesn’t lead do better functional results than conservative treatment. Surgically treated patients had a higher rate of complications.
Key words: phalangeal fractures, operative treatment, conservative treatment.
Lek Obz, 2020, 69 (9): 292-297

Agáta SZABÓOVÁ, Miroslav KILIAN, Jozef BARINKA, Jana FELDINSZKÁ, Peter JACKO, Peter ŠIMKO

Klinika úrazovej chirurgie SZU a UNB, prednosta prof. MUDr. P. Šimko, CSc.

Agáta SZABÓOVÁ, Miroslav KILIAN, Jozef BARINKA, Jana FELDINSZKÁ, Peter JACKO, Peter ŠIMKO: Non-operative versus operative treatment of extra-articular phalanx fractures of the hand. Lek Obz, 2020, 69 (9): 292-297