Juxta-epiphyseal fractures at the base of the proximal phalanx of the finger in pediatric patients

Abstract

Objectives: This study aims to evaluate the mid-term clinical and functional outcomes of juxta-epiphyseal fractures of the proximal phalanx in pediatric patients.

Patients and methods: Between July 2013 and December 2023, a total of 23 pediatric patients treated for juxta-epiphyseal fractures of the proximal phalanx were retrospectively analyzed. Functional outcomes were assessed using four subtests of the Jebsen-Taylor Hand Function Test. To compare the Jebsen-Taylor Hand Function Test, a control group of healthy children (n = 23) from the outpatient clinic was formed. Patients were treated either with closed reduction and splinting or with closed reduction followed by Kirschner wire (K-wire) fixation according to fracture displacement and stability. Radiographs were evaluated for residual deformity and malunion using Campbell’s lines.

Results: Of a total of 23 patients, 13 were male and 10 were female with a mean age of 7.24 ± 2.21 (range, 6 to 13) years. The fifth digit was the most commonly affected (n = 14), followed by the fourth (n = 5), middle (n = 2), and thumb (n = 2). In 15 patients, the injury occurred on the non-dominant hand. No malunions were detected. One patient demonstrated a pseudo-claw deformity. Hand function tests revealed statistically significant delays in patients with dominant-hand injuries compared to healthy controls (p < 0.05). Seven patients reported a change in hand dominance after injury.

Conclusion: Our study results suggest that appropriate reduction techniques, including closed or K-wire-assisted fixation, offer favorable outcomes with minimal complications. However, functional impairment can be more notable, when the dominant hand is involved. Taken together, these findings emphasize the need for early intervention, close follow-up, and consideration of hand dominance during recovery planning.

Citation: Kuşcu B, Gürbüz K. Juxta-epiphyseal fractures at the base of the proximal phalanx of the finger in pediatric patients. Jt Dis Relat Surg 2026;37(3):705-713. doi: 10.52312/jdrs.2026.2698.

B.K., K.G.: Conception, design of the work, the acquisition, analysis, prepared the figures, wrote the main manuscript, drafted the work. All authors read and approved the final manuscript.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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