Multiple drill hole osteotomy and Herbert screw for correcting a-2 years ring finger phalanx media malunion: A case report

INTRODUCTION AND IMPORTANCE: The rotational deformity is formed due to the instability of the fixation device used before in a spiral or oblique fracture pattern, and will create uncomfortable sensation also disturb daily activities. This condition usually treated with several methods of osteotomies and implants, that involving large wound and longer period of healing. CASE PRESENTATION: A 27-year-old male with chief complaint of discomfort sensation when the ring finger flexed and it was disturbing the daily activities. Two years ago, the patient was diagnosed with minimally displace closed fracture of the ring finger phalanx media and treated with buddy tapping for six months and become a malunion until now. Multiple drill hole osteotomy were made to correct the rotational position and fixed with Herbert screws. Three months follow up, the wound healed nicely and able to perform his daily activity. CLINICAL DISCUSSION: Malunion that was formed from previous inadequate treatment could make uncomfortable sensation and disturbing daily activities usually treated with large osteotomies. Multiple drill hole (MDH) usage in combination with the Herbert screw to fix the new fracture line had several advantages compared to standard methods that were previously performed. CONCLUSION: The combination of multiple drill hole and Herbert screws could be an alternative procedure with minimal surgical wounds. Without implant removal in the future, the patient can proceed to rehabilitation and return to his daily activities.