# Intra- and Extra-Articular Double-Level Osteotomy for Pediatric Malunited Proximal Phalangeal Fracture: A Case Report

## TL;DR

A 13-year-old boy with a malunited finger fracture was successfully treated with a double-level osteotomy to correct the deformity.

## Contribution

This case report presents a successful surgical approach using intra- and extra-articular osteotomy for pediatric phalangeal malunions.

## Key findings

- Surgical correction achieved near-anatomical alignment of malunited fracture fragments.
- Solid bone union was achieved eight weeks post-surgery.
- The double-level osteotomy is a viable option for pediatric bicondylar T-shaped malunions.

## Abstract

A 13-year-old boy visited our clinic due to a malunion following a phalangeal bicondylar T-shaped fracture in the proximal interphalangeal (PIP) joint of his small finger. Imaging studies showed over 2 mm of fracture displacement and ulnar deviation of the radial condyle. The patient underwent surgical correction four weeks after the initial injury. The malunited fragments were reduced to their near-anatomical positions, and an extra-articular osteotomy was performed to realign the angular deformity. Solid bone union was successfully achieved eight weeks after the corrective surgery. This intra- and extra-articular double-level osteotomy is a good option for pediatric phalangeal bicondylar T-shaped malunions.