The Pins and Rubbers Traction System for Treatment of Comminuted Intraarticular Fractures and Fracture-Dislocations in the Hand

1994 ◽  
Vol 19 (1) ◽  
pp. 98-107 ◽  
Author(s):  
Y. SUZUKI ◽  
T. MATSUNAGA ◽  
S. SATO ◽  
T. YOKOI
Keyword(s):  
Clinical Results ◽  
Skeletal Traction ◽  
Active Motion ◽  
Early Motion ◽  
Intraarticular Fractures ◽  
Fracture Dislocations ◽  
Pip Joint ◽  
Traction System ◽  
The Average Range

The authors have developed a new skeletal traction system for comminuted intraarticular fractures and fracture-dislocations in the hand. The system consists of two or three Kirschner wires and rubber bands, and is easy to assemble. It is more compact and comfortable than the banjo splint, and equally effective, and it allows early motion of the affected digits. A description of the technique is followed by the clinical results of seven cases of severe articular injuries in the hand. At the time of follow-up, the average range of the affected PIP joint motion was about 80° The final active motion of the injured DIP joint ranged from 0 to 40° in flexion and that of the affected thumb (trapezia1 fracture) was not limited. The average follow-up period was 13.1 months.

Results of Vascularized Joint Transfers from the Foot

1997 ◽  
Vol 22 (4) ◽  
pp. 492-498 ◽  
Author(s):  
G. DAUTEL ◽  
M. MERLE
Keyword(s):  
Joint Space ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Indications For Surgery ◽  
Pip Joint ◽  
Prosthetic Implant ◽  
Metatarsophalangeal Joints ◽  
Second Toe ◽  
The Average Range

We report our results in ten cases of vascularized joint transfer to reconstruct the proximal interphalangeal joint (five cases) or metacarpophalangeal joints (five cases). Donor sites were the proximal interphalangeal or the metatarsophalangeal joints of the second toe. Indications for surgery were the need to reconstruct both the growth plate and joint space in children or the impossibility of a conventional prosthetic implant. The average range of motion was 44° for the PIP joint and 53° for the MP joint at a mean follow-up of 22.7 months.

scholarly journals Complications after Displaced Talar Neck Fracture: Results from a Case Series and a Critical Review of Literature

2018 ◽  
Vol 12 (1) ◽  
pp. 567-575
Author(s):  
D. Leonetti ◽  
B. Di Matteo ◽  
P. Barca ◽  
S. Cialdella ◽  
F. Traina ◽  
...  
Keyword(s):  
Functional Performance ◽  
Case Series ◽  
Clinical Results ◽  
Fracture Dislocation ◽  
Review Of Literature ◽  
Non Union ◽  
Fracture Dislocations ◽  
Neck Fracture ◽  
Talar Fractures

Introduction: Talar fractures are uncommon injuries, whose outcome is often characterized by the onset of serious complications. The aims of the present study are: 1) to review the available evidence concerning the outcome and complications of talar neck fractures; 2) to describe the clinical results and the rate of post-op complications in a series of patients treated surgically after talar fracture-dislocations. Materials and methods: The review of the literature was performed on the Pubmed, Embase and Web of Science databases and aimed at identifying clinical trials with at least 10 patients and dealing with surgical management of talar fracture-dislocation (Hawkins grade II to IV). All the papers were analyzed to extract data concerning common complications such as non-union, mal-union, infection, osteonecrosis and osteoarthtritis. The clinical arm of this paper included 26 patients (19 men and 7 women), who underwent fixation of displaced talar fracture by cannulated screws and were retrospectively evaluated, both clinically and radiographically, at a mean 51.2 ± 23.4 months of follow-up. Results: The evaluation through the AOFAS score revelead a loss of functional performance with respect to the pre-injury status. Four patients were re-operated within final follow up, whereas the remaining 22 presented excellent results in 2 cases, good results in 4 cases, fair results in 11 cases and poor results in 5 cases. Osteoarthritis and osteonecrosis incidence were 51.9% and 25.9% respectively. Sixteen studies were included in the review and it was confirmed that the most frequent complication was post-traumatic OA, followed by osteonecrosis and mal-union. A variable range in percentage of complications described should be ascribed to the low quality of trials currently available. Conclusion: Displaced talar fracture are challenging to treat and the outcomes at middle-term are often modest. Looking at complications, the present case series and the review of literature revealed that the most common one is peritalar OA. Osteonecrosis, traditionally regarded as the most fearsome adverse event, is relevant but less frequent than OA.

Extension-Block Pinning for Unstable Dorsal Proximal Interphalangeal Joint Fracture-Dislocations: A Simple, Percutaneous Technique With Reproducible Outcomes

Hand ◽  
2022 ◽  
pp. 155894472110663
Author(s):  
Christopher A. Worgul ◽  
Andrew B. Stein
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Kirschner Wire ◽  
Proximal Phalanx ◽  
Treatment Delay ◽  
Joint Fracture ◽  
Fracture Dislocations ◽  
Pip Joint

Background: Proximal interphalangeal (PIP) joint fracture-dislocations can be technically challenging injuries to treat, and no technique has proven to be superior nor lead to predictably good outcomes. We describe our experience of treating unstable dorsal fracture-dislocations of the PIP joint with extension-block pinning (EBP) at our institution over a 22-year period. Methods: In all, 23 patients with 24 unstable dorsal fracture-dislocations of the PIP joint treated with EBP between January 1998 and October 2020 were identified. All patients underwent closed reduction of the PIP joint and insertion of a Kirschner wire into the proximal phalanx, creating a mechanical block. Range of motion and joint congruity were assessed at final clinic follow-up. Long-term function was assessed via completion of a Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. Spearman’s correlation coefficient was utilized to assess if any association existed between treatment delay, pin-in-body days, or amount of articular surface involved and QuickDASH score. Results: Mean range of motion at final follow-up was 83.3° and 22 of 24 PIP joints demonstrated a congruent reduction. In all, 15 of the 23 patients completed the QuickDASH questionnaire at a median long-term follow-up of 57.5 months (range: 3-157 months). Average QuickDASH score was 18.8, indicating minimal long-term disability. No statistically significant associations were found between treatment delay, pin-in-body days, or amount of articular surface involved and QuickDASH score. Conclusions: EBP offers a simple and innovative method to treat a complex injury of the PIP joint. It is technically straightforward and cheap, and produces excellent functional outcomes with minimal long-term disability.

Dorsal Fracture Dislocations of the Proximal Interphalangeal Joint Treated by Open Reduction and Interfragmentary Screw Fixation: Indications, Approaches and Results

2006 ◽  
Vol 31 (2) ◽  
pp. 138-146 ◽  
Author(s):  
J. Y. L. LEE ◽  
L. C. TEOH
Keyword(s):  
Open Reduction ◽  
Screw Fixation ◽  
Early Mobilization ◽  
Proximal Interphalangeal Joint ◽  
Patient Comfort ◽  
Joint Function ◽  
Fracture Dislocations ◽  
Pip Joint ◽  
Joint Congruity

Many operative and non-operative treatments of dorsal fracture dislocations of the proximal interphalageal (PIP) joint have been described. Return of good joint function requires anatomical reduction of the articular fragments and restoration of joint congruity and a stable functional arc of motion, with the fixation construct stable enough for early mobilization. To prevent recurrent dorsal subluxation, the attachments of the ligamentous palmar restraints and the bony buttress provided by the palmar lip of the middle phalanx base must be restored. Open reduction and internal interfragmentary screw fixation using 1.5 or 1.3 mm screws was employed in 12 fingers in 10 patients with unstable dorsal fracture dislocations of the PIP joints of Schenck grades III and IV. At an average follow-up of 8.7 months, all patients in this series achieved good to excellent results and an average total active interphalangeal motion of 132° (range 105°–165°). Additional benefits over non-operative techniques included improved patient comfort and simplified nursing care and therapy supervision.

Clinical Results of Intraarticular Fractures of the Base of the Fifth Metacarpal Treated by Closed Reduction and Cast Immobilization

2000 ◽  
Vol 25 (3) ◽  
pp. 258-261 ◽  
Author(s):  
J. M. LUNDEEN ◽  
A. Y. SHIN
Keyword(s):  
Retrospective Study ◽  
Closed Reduction ◽  
Clinical Results ◽  
Fracture Type ◽  
Carpometacarpal Joint ◽  
Cast Immobilization ◽  
Intraarticular Fractures

This retrospective study evaluated the results of closed reduction and cast immobilization for isolated intraarticular fractures of the base of the fifth metacarpal. Twenty-two of 37 such fractures were available for follow-up at an average of 43 months, and these had all healed at an average of 5 weeks without any cast complications. Twenty patients reported excellent or good results, and two reported fair or poor results. At follow-up, 13 had no arthrosis and nine had mild arthrosis of the carpometacarpal joint. However, outcome was not influenced by fracture type, the degree of subluxation or articular step off, or the presence of arthrosis. We conclude that isolated fractures of the base of the fifth metacarpal can be reliably treated with closed reduction and cast immobilization.

The Stockport Serpentine Spring System for the Treatment of Displaced Comminuted Intra-Articular Phalangeal Fractures

1990 ◽  
Vol 15 (3) ◽  
pp. 303-311
Author(s):  
N. R. M. FAHMY
Keyword(s):  
Active Motion ◽  
Fracture Dislocations ◽  
Total Active Motion ◽  
Spring System ◽  
Phalangeal Fractures ◽  
New System

A new system has been designed to treat displaced comminuted intra-articular phalangeal fractures and 20 such fracture-dislocations were treated by it. Nineteen of the patients were satisfied at an average follow-up period of 13.6 months, with a mean total active motion of 226°. The results are rewarding considering the gravity of the injuries.

PERCUTANEOUS PINNING OF THE DISPLACED VOLAR PLATE AVULSION FRACTURE OF THE PIP JOINT

Hand Surgery ◽  
2009 ◽  
Vol 14 (02n03) ◽  
pp. 113-119 ◽  
Author(s):  
Masayoshi Ikeda ◽  
Takayuki Ishii ◽  
Yuka Kobayashi ◽  
Joji Mochida ◽  
Ikuo Saito ◽  
...  
Keyword(s):  
Avulsion Fracture ◽  
Volar Plate ◽  
Bony Union ◽  
Large Fragment ◽  
Operative Techniques ◽  
Active Motion ◽  
Level Of Invasion ◽  
Pip Joint ◽  
K Wires

The use of operative or non-operative techniques in the treatment of a volar plate avulsion fracture of the PIP joint has remained controversial. In this study, we describe the use of percutaneous K-wire fixation in 15 patients with a displaced and rotated large fragment of this injury. All processes of the technique, including reduction and interfragmental fixation, were performed with percutaneous K-wires. Mean follow-up was 14.2 months. All patients achieved bony union. Mean active motion was -1.3°/86.2° for the PIP joint and 0°/77.5° for the DIP joint and mean %TAIM was 94.6%. There were no complications. No patients complained of pain and all were able to return to their previous activity. Although this procedure is technically demanding, it reconstructs a rotated or displaced large volar plate avulsion with a low level of invasion, and achieves a satisfactory functional recovery.

scholarly journals Early clinical results of volar plate arthroplasty for neglected fracture dislocations of pip joint in hand

2018 ◽  
Vol 4 (1f) ◽  
pp. 398-400
Author(s):  
Mohit Dhingra ◽  
Sumit Kumar ◽  
Pankaj Sharma ◽  
Jabreel Muzaffar ◽  
Misbah Mehraj ◽  
...  
Keyword(s):  
Clinical Results ◽  
Volar Plate ◽  
Fracture Dislocations ◽  
Pip Joint

Hemihamate arthroplasties in pilon fractures: a modified approach and experience in 30 patients

2021 ◽  
pp. 175319342110080
Author(s):  
Gopal Malhotra ◽  
Zamzam Hamed Al Bahri ◽  
Ahmed Osama Abdelhamed Elsayed ◽  
Venkata Nageshwara Reddy Komma ◽  
Rahul Patil
Keyword(s):  
Established Method ◽  
Level Of Evidence ◽  
Joint Fractures ◽  
Pip Joint ◽  
Secondary Procedures ◽  
The Average Range ◽  
Pilon Fractures

Hemihamate arthroplasty is an established method of managing difficult Pilon fractures of the proximal interphalangeal (PIP) joint. We present our experience in 30 patients, whose injuries were further complicated by severe comminution and late presentations. Several modifications were utilized, including preoperative distraction, use of smaller size grafts and functional release of collaterals. The average follow-up period was 28 months (range 18 to 28). Postoperatively, the average range of flexion at the PIP joint improved from 30° (range 20° to 45°) preoperatively to 104° (90° to 110°) at the final follow-up. The average extension lag was 6° (0° to 20°). Five patients required secondary procedures and no patient had a recurrent dorsal dislocation. We propose these modifications in the use of hemihamate arthroplasty for the management of difficult PIP joint fractures. Level of evidence: IV

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