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Review
. 2020 Nov-Dec;28(6):318-322.
doi: 10.1590/1413-785220202806236612.

HALLUX PROXIMAL PHALANX FRACTURE IN ADULTS: AN OVERLOOKED DIAGNOSIS

Alexandre Leme Godoy-Santos  1 , Vincenzo Giordano  2 , Cesar DE Cesar  3 , Rafael Barban Sposeto  1 , RogÉrio Carneiro Bitar  4 , AndrÉ Wajnsztejn  5 , Marcos Hideyo Sakaki  1 , TÚlio Diniz Fernandes  1
Affiliations
Review

HALLUX PROXIMAL PHALANX FRACTURE IN ADULTS: AN OVERLOOKED DIAGNOSIS

Alexandre Leme Godoy-Santos et al. Acta Ortop Bras. 2020 Nov-Dec.

Abstract
in English, Portuguese

Objectives: To describe the surgical treatment of fractures that involves the hallux interphalangeal joint, current indications and management options.

Methods: we performed a literature review of relevant clinical studies in multiple databases, including PubMed, MedLine and Scopus, from January 1989 to October 2020.

Results: There is consensus for surgical treatment of intra-articular fractures with a deviation greater than 2 mm, metadiaphyseal fractures with malrotation and/or malangulation, open fractures and unstable fractures.

Conclusion: The use of more rigid implants allow alignment maintenance during healing process and lower risk of reduction loss. Valgus deformity and interphalangeal joint osteoarthritis are possible complications that must be avoided. Level of Evidence III, Systematic review of Level III studies.

Objetivos: destacar o tratamento cirúrgico das fraturas que envolvem a articulação interfalangiana do hálux, suas indicações atuais e as opções de tratamento.

Métodos: Realizamos uma revisão da literatura de estudos clínicos relevantes em múltiplas bases de dados, incluindo PubMed, MedLine e Scopus, de janeiro de 1989 a outubro de 2020.

Resultados: Há consenso para o tratamento cirúrgico de fraturas intra-articulares com desvio superior a 2 mm, fraturas metadiafisárias com má rotação e/ou malangulação, fraturas expostas e fraturas instáveis.

Conclusão: O uso de implantes mais rígidos permite a manutenção do alinhamento durante o processo de consolidação e menor risco de perda da redução. As complicações que devem ser evitadas são a deformidade em valgo e a osteoartrite da articulação interfalangeana. Nível de Evidência III, Revisão sistemática de Estudos de Nível III.

Keywords: Fracture Fixation; Hallux; Treatment Outcome.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. AO Foundation/Orthopaedic Trauma Association coding classification system forefoot.
Figure 2
Figure 2. A: crossed K-wires; B: lag screws; C: lag screw and neutralization plate; D: neutralization plate and lag screw through plate; and E: “T” dorsal plate.
Figure 3
Figure 3. A and B: preoperative CT sagittal and axial view; C: intra-operative hallux distraction; D, E and F: plate cutting in an appropriate length, molding and bending to contour it to the bone; G and H: postoperative oblique and anteroposteior conventional radiographic images of hallux proximal phalanx fracture.
See this image and copyright information in PMC

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