Needle-in-needle Pinning Technique Using Disposable Hypodermic Needles for Fractures of Distal Phalanx With Dorsal Disruption

Fingertip injuries are frequently encountered by the hand surgeon, and often present with a combination of the following: avulsed or broken nail plate, nail bed disruption, and/or distal phalangeal fracture. Recommended management of these injuries consists of reduction of the fracture followed by repair of soft tissues. To achieve an anatomic reduction and sufficient stability of the fracture, current management consists of temporary Kirschner-wire stabilization. Hypodermic needles can be substituted to secure temporary transosseous fixation. We describe a technique for stabilizing open distal phalangeal fracture using hypodermic needles which are readily available. Eight patients over 12 months have been treated with this technique which has proven to be successful. We would advocate that providers consider this technique when Kirschner-wires or other necessary instruments are unavailable.