Correction of Distal Phalangeal Nonunion Using Peg Bone Graft

PurposeTo evaluate the outcome of a peg bone graft for treatment of distal phalangeal nonunion, in terms of safety and effectiveness.MethodsWe performed grafts using bone pegs in 13 patients who reported pain and instability of the fingertip as a result of distal phalanx nonunion. Surgical procedures included harvesting cancellous and cortical bone from ilium, radius, or ulna. We made a small incision in the fingertip and placed the bone pegs through the canal created for this access. In a few cases in which the bone peg did not offer mechanical stability, we used K-wires for additional support.ResultsAll patients had successful union of the distal phalanx without serious complications in either donor or recipient areas. Range of motion improved postoperatively. An additional operation was needed in 1 case.ConclusionsThe use of a peg bone graft in the treatment of distal phalanx nonunion offers easy access to the nonunion area and allows for effortless internal fixation. The bone contact area was increased, resulting in bone union and stability. Therefore, bone peg graft could be considered a potential method for the treatment of distal phalanx nonunion.Type of study/level of evidenceTherapeutic IV.