{"title":"Double X Configuration Screw Fixation for Middle Phalanx Fracture - A Case Report.","authors":"Mojahed Sakhnini","doi":"10.13107/jocr.2025.v15.i02.5262","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Techniques for treating phalangeal fractures are evolving. Intramedullary screws are a trendy surgical choice that leads to optimal results. Metacarpals and proximal phalanges could tolerate two screws. We want to demonstrate that middle phalanx fractures could also be treated with double-cannulated screws.</p><p><strong>Case report: </strong>A 19-year-old patient with a middle phalanx fracture of the 4th left digit was treated with Kirschner wires leading eventually to malunion. We revised the fracture with a redo, recreating the fracture and introducing retrograde crossed-cannulated screws with excellent stability that allowed an immediate range of motion. The patient achieved union with full grip and range of motion.</p><p><strong>Conclusion: </strong>Middle phalanx fractures could be treated with two screws in a crossed configuration achieving stable fixation and obviating the proximal interphalangeal joint.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"146-149"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823848/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.13107/jocr.2025.v15.i02.5262","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Introduction: Techniques for treating phalangeal fractures are evolving. Intramedullary screws are a trendy surgical choice that leads to optimal results. Metacarpals and proximal phalanges could tolerate two screws. We want to demonstrate that middle phalanx fractures could also be treated with double-cannulated screws.
Case report: A 19-year-old patient with a middle phalanx fracture of the 4th left digit was treated with Kirschner wires leading eventually to malunion. We revised the fracture with a redo, recreating the fracture and introducing retrograde crossed-cannulated screws with excellent stability that allowed an immediate range of motion. The patient achieved union with full grip and range of motion.
Conclusion: Middle phalanx fractures could be treated with two screws in a crossed configuration achieving stable fixation and obviating the proximal interphalangeal joint.
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