Pseudarthrosis and ¶delayed consolidation of the distal phalanges.

The digital fractures are caused by a compression of the pulp and nail. These fractures, which are almost always open, will hinder the consolidation of the phalanx leading to a delay of consolidation beyond three months, and a pseudoarthrosis beyond six months. Material 15 patients presented 25 cases of delayed union or pseudarthrosis of the distal phalanx in 10 years. The long finger was the most affected the dominant right side the most affected. The fracture was most often simple, proximal diaphysometaphysial. It was an accident at work in 14 cases among manual workers. The initial treatment consisted of wound care with a repositioning of the finger. It was orthopaedic in 8 cases of complex fractures, and surgical in 17 cases of simple fractures with failure of reduction. Method The secondary surgical revision took place between 8 months and 40 months with an average of 12 months. The approach is lateral and allows freshening and control of the interfragmentary compression during the pinning on; Results 23 very good and good results, and 2 cases of amputation due to a secondary sepsis were noted. All lesions of the distal phalanxes must be treated urgently at the same time including wound care, treatment of lesions of the ungual system and site synthesis by pin. The delay of consolidation and the pseudoarthrosis should be treated surgically with lateral approach, exposure and curettage of the site, compression with spongy grafting and, in case of loss of substance, spongy grafting, blocking pinning on and splint.