{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T08:26:59Z","timestamp":1787128019613,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Metacarpal and phalangeal nonunion is rare; however, surgery is required if these fractures result in instability or persistent pain. Revision of nonunion following plate fixation is challenging, as it demands bone grafting at the nonunion site and stable fixation. Here, we present a surgical technique for managing metacarpal and phalangeal nonunion after failed plate fixation using an intramedullary strut bone peg reinforced with intramedullary K-wires. This technique achieves a high union rate by increasing the intramedullary contact surface, promoting bone healing. Moreover, intramedullary K-wires bypass previous screw holes and help maintain fracture apposition and alignment at the nonunion sites.<\/jats:p>","DOI":"10.1097\/bth.0000000000000558","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T08:00:09Z","timestamp":1776758409000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Intramedullary Strut Bone Peg Technique for Revision of Metacarpal and Phalangeal Nonunion After Failed Plate Fixation"],"prefix":"10.1097","volume":"30","author":[{"given":"Hui-Kuang","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan"},{"name":"Center for Nerve Repair and Reconstruction, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan"},{"name":"Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"Department of Food Nutrition, Chung Hwa University of Medical Technology, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hsun","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan"},{"name":"Center for Nerve Repair and Reconstruction, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Hsien","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan"},{"name":"School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsien-Chi","family":"Chang","sequence":"additional","affiliation":[{"name":"Center for Nerve Repair and Reconstruction, Ditmanson Medical Foundation Chiayi 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