Compound distal phalanx fractures are a commonly managed presentation in many Plastic Surgery units. Most published literature that includes the infective complications of this condition focusses on open mallet fractures or conservatively managed tuft fractures, which reflect only a portion of the compound distal phalanx injuries that we manage routinely in our unit.
Infection in this location ranges from superficial infection of the soft tissue envelope, osteomyelitis, or septic arthritis of the DIPJ. Osteomyelitis and septic arthritis here can result in significant morbidity, with extended antibiotic treatment, traumatic arthritis and potential amputation. Therefore, it is important to be able to anticipate patient and presentation features that can lead to poor outcomes in order to optimise treatment.
An audit of medical records for all patients over a two year period treated by our service for compound distal phalanx fractures was performed to identify infection rates and their relation to patient and presentation risk factors, as well as treatment modality. Available microbiology was also collated to provide further data regarding the local flora responsible for infective complications in this population.
Here we present the results of this audit and outline the rates of infective complications in our compound distal phalanx fracture patients, stratifying these by risk factors that can be recognised and treated accordingly.