الفهرس 
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Abstract
Fifty-eight cases with sixty-four simple recent
f::cacturesof the proximal and middle phalanges in the hand
were subjected to through clinical and radiographic examination.
The aim was to evaluate the various surgical and conservative
methods of treatment with analysis of the results
achieved and study of the complications following each
method.
In 64 finger fractures, the thumb were affected in
Eight cases (12.5%), the index in 7 cases(lO.9%), the
middle in 15 cases (23.5%), the ring in 16 cases (25%)
and the little in 18 cases (28.1%).
The proximal phalanx were involved in (92.2%) and the
middle phalanx in 7.8%. A history of indirect trauma was
obtained in 75.9% and direct trauma in 24.1%.
Manipulation and plaster of Paris fixation or open
reduction with Kirschner-wire fixation were the methods
of treatment applied to the patients in this series,
selection being based on the type and judged stability of
the fracture.
Forty cases were treated conservatively 82.5% good
results were obtained. It is indicated for undisplaced
fractures , stable fractures, eQipbyseal separation and
spi~al fractures. It was evident that the younger the
patient the more favourable was the result(93.6%, good
results below 30 years of age).
The results obtained after conservative treatment were
better than after open reduction because cases treated conservatively
we~e undisplaced and stable (adhesions less).
Complications met with after manipulation and plaster
fixation were flexion deformity up to 40 degrees in 28.3% of
this series from adhesions and lack of exercises. Malrotation
4.3% with overriding of the fingers due to d1splacemeut
in plaster or imperfect reduction.
4.3% of the cases showed malunion with angulation deformities
this were due to displaoements in plaster from muscle pull.
Eighteen cases were treated by open reduction and
Kirschner wire fixation, the ~esults were 77.8% satisfactory
(50% wez-e good and 27.8 fai::’). It is indicated for displaced
intra-articular fractures, unstable fractures,
severely displaced fractures and failed conservative treatment.
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It was evident that the younger the individual the
mo~e favourable was the results. Comparing patients below
thi~ty years of age and above thirty years the results were
(63.3% and 28.6% good results ~espectively). Males also
gave better results than females after open reduction.
Complications metwith after open reduction were 16.7%
show flexion deformity from 30 - 50 degrees, this were due
to adhesions of tendons to the fracture site and lack of
exercises. 11.2% show angulation deformity, 16.7% Bhow
mal~otation. 5.6% (only one case) show skin infection and
no cases of delayed union or non union.
Meticulous technique and gentle handling of the tissues
with early motion and exercises to maintain muscle length,
reduce oedema prevent adhesion of tendons and contracture
of ligaments are essential for the achievement of best
results.