Chronic fracture dislocation of the proximal interphalangeal joint—Treatment by osteotomy and bone graft

1981 ◽  
Vol 6 (5) ◽  
pp. 447-455 ◽  
Author(s):  
Norman P. Zemel ◽  
Herbert H. Stark ◽  
Charles R. Ashworth ◽  
Joseph H. Boyes
2016 ◽  
Vol 21 (03) ◽  
pp. 382-387 ◽  
Author(s):  
Andre Eu-Jin Cheah ◽  
Tun-Lin Foo ◽  
Janice Chin-Yi Liao ◽  
Min He ◽  
Alphonsus Khin-Sze Chong

Background: Proximal interphalangeal joint (PIPJ) dorsal fracture dislocations (DFD) are challenging injuries. Treatment aims to achieve stability of the PIPJ after reduction so that early motion can be initiated. We studied how increasing articular destruction would affect post reduction stability and investigate the amount of traction and PIPJ flexion needed to maintain the reduction. Methods: Increasing amounts (20%, 40% and 60%) of damage to the volar lip of the middle phalanx in cadaveric specimens were created to represent PIPJ DFD that were stable, of tenuous stability and frankly unstable. Traction forces and PIPJ flexion needed to maintain the reduction were then measured. Results: The PIPJ DFD with 20% damage were stable and did not subluxe while the one with 40% articular involvement was stable after reduction. For unstable the PIPJ with 60% involvement, the more the PIPJ was flexed, the less traction force was needed to hold the joint in reduction. For PIPJ flexion of 20 degrees, a minimum 4.4N of force is needed to maintain reduction while PIPJ flexion of 10 degrees required a minimum 5.0N of force. No amount of force could maintain PIPJ reduction if traction was performed in full extension. Conclusions: In our model, PIPJ DFD with less than 30% articular damage are stable while those with 30% to 50% of involvement have tenuous stability. For the unstable PIPJ DFD, traction obviates the need for excessive flexion of the PIPJ to maintain joint reduction. This information should be considered in treatment modalities for PIPJ DFD, as well in the design of external traction devices for the treatment of PIPJ DFD.


1998 ◽  
Vol 23 (6) ◽  
pp. 798-801 ◽  
Author(s):  
O. ISHIDA ◽  
Y. IKUTA

We reviewed 20 cases of chronic dorsal fracture-dislocation of the proximal interphalangeal joint, with a mean follow-up period of 74 months. In patients without comminuted palmar fragments, open reduction and internal fixation or osteotomy of the malunited fragment provided good results. In treating patients with damaged articular cartilage or with comminuted palmar fragments by palmar plate arthroplasty, poor results were obtained because of secondary osteoarthritic changes.


2007 ◽  
Vol 32 (2) ◽  
pp. 193-194 ◽  
Author(s):  
K. OTANI ◽  
K. FUKUDA ◽  
C. HAMANISHI

A case of dorsal fracture–dislocation of the proximal interphalangeal joint in which the volar plate had been pulled from its distal attachment without bony or cartilaginous attachments and the lip of the volar plate had also been detached separately and was obstructing full flexion of the joint is presented. A tentative mechanism of causation of this unusual variant of a common injury is suggested.


2003 ◽  
Vol 93 (3) ◽  
pp. 167-173 ◽  
Author(s):  
Kieran T. Mahan ◽  
Michael S. Downey ◽  
Glenn D. Weinfeld

Digital surgery is one of the most common types of surgery performed by foot and ankle surgeons. Flail toe is a complication that may occur after overaggressive resection arthroplasty of the proximal interphalangeal joint of the lesser toes. Correction of flail toe deformity has received little attention and has predominantly involved soft-tissue procedures. The authors’ preferred technique for the surgical correction of flail toe is to place a unicortical autogenous bone graft (harvested from the ipsilateral calcaneus) within the revised proximal interphalangeal joint of the lesser toes to create a distraction arthrodesis. This technique allows restoration of digital length, stability, and purchase. A retrospective review of 22 such procedures in 13 patients is presented, along with a literature review of other procedures and a description of the authors’ current surgical technique and postoperative management protocol. Overall success using the authors’ procedure was 82%. Complications occurred in three patients, with one of the grafts showing complete resorption and two requiring additional surgical intervention owing to nonunion and malunion of toes. (J Am Podiatr Med Assoc 93(3): 167-173, 2003)


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