The Treatment of Chronic Flexion Contractures of the Proximal Interphalangeal Joint

1995 ◽  
Vol 20 (3) ◽  
pp. 385-389 ◽  
Author(s):  
G. ABBIATI ◽  
G. DELARIA ◽  
E. SAPORITI ◽  
M. PETROLATI ◽  
C. TREMOLADA
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Extension Deficit ◽  
Flexion Contractures ◽  
Complete Extension ◽  
Pip Joint ◽  
Surgical Release

A method of treatment of chronic flexion contractures of the PIP joint is presented, with the results obtained in 19 patients treated between 1989 and 1992 after a follow-up of from 6 to 53 months. The flexion contractures, with an extension deficit which ranged between 70 and 90°, had been present for a period of between 2 months and 24 years. Our treatment program involves the surgical release of the unreducible PIP joint followed by the use of static and/or dynamic splints. Surgery is performed using a midlateral approach; the accessory collateral ligament and the flexor sheath are incised and, after the volar plate and check-rein ligaments have been excised, forced hyperextension is applied. The main collateral ligaments are carefully spared and freed from the condyle if there are any remaining adhesions. In our 19 patients, complete extension of the finger was achieved in 11 cases (57.9%); in the remaining 8 cases (42.1%) the residual extension deficit ranges from 10 to 15°. In our experience this combined surgical and rehabilitative approach had led to consistently good results with minimal complications.

Irreducible Volar Rotatory Subluxation of the Proximal Interphalangeal Joint of the Finger

2018 ◽  
Vol 23 (01) ◽  
pp. 111-115
Author(s):  
Masahiko Tohyama ◽  
Sadahiko Konishi
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Lateral View ◽  
Interphalangeal Joint ◽  
Collateral Ligaments ◽  
Middle Phalanx ◽  
Collateral Ligament ◽  
Pip Joint ◽  
Central Slip ◽  
Rotatory Subluxation ◽  
Careful Physical Examination

We describe 4 cases of irreducible volar rotatory subluxation of the proximal interphalangeal (PIP) joint of the finger that required open reduction. All of the patients had radiographically proven (in lateral-view radiographs) volar rotatory subluxation of the PIP joint, without fracture. The causes of irreducibility were interposition of the lateral band about the condyle of the middle phalanx in 2 cases, interposition of the collateral ligament in 1 case, and scarring of the injured central slip in 1 case. Rupture of the collateral ligament of one side was found in all cases. Acceptable results were provided with all cases after restoration of the collateral ligaments and the damaged parts. Accurate early diagnosis by careful physical examination and obtaining true lateral radiographs of the PIP joint is important.

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.

Area of cartilage accessible to curettage for subsequent arthrodesis of the equine proximal interphalangeal joint

2013 ◽  
Vol 26 (06) ◽  
pp. 489-492 ◽  
Author(s):  
S. Berchtold ◽  
J. M. Kuemmerle
Keyword(s):  
Articular Cartilage ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Disease ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Contralateral Limb ◽  
Conventional Procedure ◽  
Articular Cartilage Surface ◽  
The Difference

SummaryThis study compared the areas of cartilage accessible for curettage in arthrodesis of the equine proximal interphalangeal joint using the conventional and collateral ligament sparing approaches. For this purpose, forelimbs and hindlimbs of six equine cadavers without radiographic evidence of proximal interphalangeal joint disease were used. One limb of each pair of limbs was randomly assigned to a dissection using a standard approach to the proximal interphalangeal joint including transection of the collateral ligaments, while each contralateral limb was exposed using the same approach but leaving the collateral ligaments intact. Hohmann retractors and Spratt curettes were then used to remove as much articular cartilage as possible. Finally, proximal interphalangeal joints were photographed and image analysis was performed.Using the collateral ligament sparing procedure, the mean percentage of articular cartilage surface removed (41.2%) was significantly less than using the conventional procedure (79.6%) (p <0.01). The difference between forelimbs and hindlimbs was not significant.

The extensor tendon splitting approach to the proximal interphalangeal joint: do we need to reinsert the central slip?

2009 ◽  
Vol 35 (3) ◽  
pp. 188-191 ◽  
Author(s):  
A. M. Afifi ◽  
A. Richards ◽  
A. Medoro ◽  
D. Mercer ◽  
M. Moneim
Keyword(s):  
Extensor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Dorsal Approach ◽  
Pip Joint ◽  
Central Slip ◽  
Extensor Lag

Current approaches to the proximal interphalangeal (PIP) joint have potential complications and limitations. We present a dorsal approach that involves splitting the extensor tendon in the midline, detaching the insertion of the central slip and repairing the extensor tendon without reinserting the tendon into the base of the middle phalanx. A retrospective review of 16 digits that had the approach for a PIP joint arthroplasty with a mean follow up of 23 months found a postoperative PIP active ROM of 61° (range 25–90°). Fourteen digits had no extensor lag, while two digits had an extensor lag of 20° and 25°. This modified approach is fast and simple and does not cause an extensor lag.

scholarly journals Clinical Outcomes of Operative Repair for Patients Who Fail to Conserve the Complete Rupture of the Collateral Ligament in the Proximal Interphalangeal Joint

2021 ◽  
Vol 27 (2) ◽  
pp. 81-84
Author(s):  
Young Hwan Kim
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Stress Test ◽  
Visual Analog Scale Score ◽  
Proximal Interphalangeal Joint ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Complete Rupture ◽  
Pip Joint

Objective: The purpose of this study was to compare the preoperative and postoperative outcomes of surgical treatment for patients who fail to conserve the complete rupture of the collateral ligament in the proximal interphalangeal (PIP) joint.Methods: A complete rupture of the collateral ligament was confirmed by a radiologist using ultrasound or magnetic resonance imaging for patients who had symptoms after 4 weeks of conservative treatment. Eleven patients underwent operative collateral ligament repair using an anchor. All patient was followed up for at least 6 months postoperatively. We evaluated clinical outcomes preoperatively and at 6 months follow-up: (1) range of motion of the PIP, (2) joint stability, (3) Visual Analog Scale score, (4) fusiform index of the PIP joint, and (5) functional & cosmetic satisfaction.Results: There was no instability in the lateral stress test at 6-month follow-up. The ranges of motion of the PIP were not statistically different between preoperative and at 6-month follow-up. Patients had less pain but the cosmetic appearance of the PIP joint did not improve. Functional satisfaction differed statistically, but there was no difference in cosmetic satisfaction.Conclusion: Surgical treatment for patients who fail to conserve the complete rupture of the collateral ligament in the PIP joint can provide good joint stability, functional recovery.

TWO TO FIVE YEAR FOLLOW-UP OF THE LPM CERAMIC COATED PROXIMAL INTERPHALANGEAL JOINT ARTHROPLASTY

2008 ◽  
Vol 33 (1) ◽  
pp. 38-44 ◽  
Author(s):  
J. FIELD
Keyword(s):  
Clinical Signs ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Pip Joint ◽  
Joint Implants ◽  
Post Traumatic ◽  
Joint Arthroplasties ◽  
Traumatic Arthritis

This paper presents a retrospective series of 20 LPM semi-constrained ceramic coated cobalt chrome proximal interphalangeal joint arthroplasties performed consecutively in 12 patients for arthritis of the proximal interphalangeal joint by a single surgeon between 2000 and 2004. Eleven were performed for osteoarthritis, four for post-traumatic arthritis and five for rheumatoid arthritis. Although 12 joints had an improvement in pain and an increased functional arc of movement, six joints required revision surgery for implant failure at an average of 19 months, with clinical signs of increasing pain, deteriorating motion and radiological signs of implant loosening and subsidence. This rate of revision is higher than in published series for other PIP joint implants and, therefore, close surveillance of all patients with this prosthesis currently in situ is recommended. Use of the prosthesis has ceased in this unit.

Reconstruction of finger pulp defects using homodigital dorsal middle phalangeal neurovascular advancement flap

2009 ◽  
Vol 35 (2) ◽  
pp. 125-129 ◽  
Author(s):  
K. Özaksar ◽  
T. Toros ◽  
T. S. Sügün ◽  
E. Bal ◽  
Y. Ademoğlu ◽  
...  
Keyword(s):  
Advancement Flap ◽  
Mean Value ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Discrimination Test ◽  
Extension Deficit ◽  
Flap Procedure ◽  
Neurovascular Pedicle ◽  
The Mean

Eighteen finger pulp defects were reconstructed using a homodigital dorsal middle phalangeal neurovascular island flap procedure based on a single neurovascular pedicle preserving the length of the finger. All flaps survived and achieved adequate functional and cosmetic results. The mean follow-up time was 22 months. The mean value of static two-point discrimination test of the healed flaps was 7 mm and the mean value of moving two-point discrimination test was 5 mm. Range of motion was considered satisfactory in all reconstructed fingers except one, in which a 20° extension deficit at the proximal interphalangeal joint was observed. This flap represents a useful alternative for reconstruction of the fingers with large pulp defects.

scholarly journals Complete Avulsion of the Extensor Mechanism of a Finger with Simultaneous Dislocation of the Proximal Interphalangeal Joint

2009 ◽  
Vol 3 (1) ◽  
pp. 75-77 ◽  
Author(s):  
K.C Xarchas ◽  
K Tilkeridis ◽  
G Kitsikidou ◽  
S.I Pelekas ◽  
D.A Verettas
Keyword(s):  
Ulnar Collateral Ligament ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Extensor Mechanism ◽  
Collateral Ligament ◽  
Rare Injury ◽  
Single Finger ◽  
Extensor Apparatus ◽  
Pip Joint ◽  
Mechanism Operative

We report a rare case of open dislocation of the proximal interphalangeal (PIP) joint, associated with simultaneous avulsion of the central band and distal insertion of the extensor mechanism, rapture of the proximal volar plate, and rapture of the ulnar collateral ligament of the PIP joint. Although isolated IP joint injuries are common, they rarely occur simultaneously in a single finger. Even more rarely are they accompanied by a complete avulsion of the extensor mechanism. Operative restoration of the injured structures is a necessity in order to achieve a good functional outcome. An initial forceful flexion of the finger resulting to rapture of the extensor apparatus and then followed by finger hyperextension and PIP joint dislocation is our perception of the possible mechanism of this extremely rare injury.

Comparison of outcomes of three surgical approaches for proximal interphalangeal joint arthroplasty using a surface-replacing implant

2019 ◽  
Vol 45 (6) ◽  
pp. 608-614 ◽  
Author(s):  
Elvira Bodmer ◽  
Miriam Marks ◽  
Stefanie Hensler ◽  
Stephan Schindele ◽  
Daniel B. Herren
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Surgical Approaches ◽  
Joint Motion ◽  
Extension Deficit ◽  
Level Of Evidence ◽  
Volar Approach ◽  
The Mean

The objective was to compare outcomes of the volar, Chamay and tendon splitting approaches for proximal interphalangeal joint arthroplasty using a surface-replacing implant (CapFlex-PIP). One-hundred prospectively documented patients with a 2-year follow-up were included. Range of proximal interphalangeal joint motion, the brief Michigan Hand Outcomes Questionnaire and complications were analysed. Between baseline and follow-up, mean proximal interphalangeal joint motion increased for the volar (53° to 54°), Chamay (38° to 53°) and tendon splitting (40° to 61°) approaches. The volar approach yielded the greatest flexion and the highest extension deficit. The mean brief Michigan Hand Outcomes Questionnaire scores at baseline and 2 years were 45 and 74 (volar), 45 and 66 (Chamay) and 41 and 75 (tendon splitting). Seven patients in the Chamay group and two in the volar group required a reoperation consisting of teno-/arthrolysis. The tendon splitting approach tended to result in the best outcomes that were associated with fewer complications compared with the volar and Chamay approaches. Level of evidence: IV

scholarly journals Volar Plate Avulsion of Pip Joint: An Unusual Fielding Injury in Cricket

2015 ◽  
Vol 49 (4) ◽  
pp. 209-212
Author(s):  
Sharad Prabhakar ◽  
Himmat Singh Dhillon ◽  
Kevin Syam ◽  
Sidak Singh Dhillon ◽  
Mandeep Singh Dhillon
Keyword(s):  
Soft Tissue ◽  
Team Sport ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Hand Injuries ◽  
Volar Plate ◽  
Finger Injuries ◽  
Pip Joint ◽  
Unusual Injury

ABSTRACT Fielding injuries are the predominant contact injury in cricket, with the fingers taking the blunt of the trauma due to direct hit by the ball while taking catches. Many types of hand and finger injuries like soft tissue contusions, fractures/dislocations and ligament and joint sprains have been observed in this popular team sport. One of the unique kind of hand injuries associated with cricket is the avulsion of the volar plate of the proximal interphalangeal joint (PIP). Here, we report this unusual injury in a 24-year-old cricketer, its management and 3-month follow-up along with a review of hand injuries in cricket. How to cite this article Prabhakar S, Dhillon HS, Syam K, Dhillon SS, Dhillon MS. Volar Plate Avulsion of Pip Joint; An Unusual Fielding Injury in Cricket. J Postgrad Med Edu Res 2015;49(4):209-212.

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