Intermediate-Term Experience of Pipkin Fracture-Dislocations of the Hip

Intra-articular fracture dislocations of the base of the middle phalanx are complex and debilitating injuries that present a management conundrum when nonreconstructable. Hemi-hamate arthroplasty (HHA) is a treatment modality of particular use in the setting of highly comminuted fractures. This systematic review aims to summarize the reported outcomes of HHA in this context. A literature search was conducted using MEDLINE, Embase, and PubMed, yielding 22 studies with 235 patients for inclusion. The weighted mean postoperative range of movement at the proximal interphalangeal joint was 74.3° (range, 62.0°-96.0°) and at the distal interphalangeal joint was 57.0° (range, 14.0°-80.4°). The weighted mean postoperative pain Visual Analog Scale was 1.0 (range, 0.0-2.0). The weighted mean postoperative grip strength was 87.1% (range, 74.5%-95.0%) of the strength on the contralateral side. Posttraumatic arthritis was reported in 18% of cases, graft collapse in 4.2%, and donor site morbidity in 3.0%, with a mean follow-up period of 28.4 months (range, 1-87 months). Hemi-hamate arthroplasty is a reliable and effective technique for the reconstruction of intra-articular base of middle phalangeal fracture dislocations, affording symptomatic relief and functional restoration. Further research is required to assess the true incidence of long-term complications.

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Post-Reduction Stability of the Proximal Interphalangeal Joint after Dorsal Fracture Dislocation—A Cadaveric Study

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835516500387 ◽

2016 ◽

Vol 21 (03) ◽

pp. 382-387 ◽

Cited By ~ 1

Author(s):

Andre Eu-Jin Cheah ◽

Tun-Lin Foo ◽

Janice Chin-Yi Liao ◽

Min He ◽

Alphonsus Khin-Sze Chong

Keyword(s):

Traction Force ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Fracture Dislocation ◽

Treatment Modalities ◽

Full Extension ◽

Early Motion ◽

Fracture Dislocations ◽

Reduction Stability ◽

The One

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.

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Newly developed anatomical and functional ligament reconstruction for the Lisfranc joint fracture dislocations: A case report

Foot and Ankle Surgery ◽

10.1016/j.fas.2014.04.005 ◽

2014 ◽

Vol 20 (3) ◽

pp. 221-223 ◽

Cited By ~ 7

Author(s):

Takaaki Hirano ◽

Hisateru Niki ◽

Moroe Beppu

Keyword(s):

Case Report ◽

Ligament Reconstruction ◽

Lisfranc Joint ◽

Joint Fracture ◽

Fracture Dislocations

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Results of Treatment of Chronic Dorsal Fracture-Dislocations of the Proximal Interphalangeal Joints of the Fingers

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(98)80101-0 ◽

1998 ◽

Vol 23 (6) ◽

pp. 798-801 ◽

Cited By ~ 11

Author(s):

O. ISHIDA ◽

Y. IKUTA

Keyword(s):

Articular Cartilage ◽

Internal Fixation ◽

Open Reduction ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Fracture Dislocation ◽

Results Of Treatment ◽

Palmar Plate ◽

Fracture Dislocations

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.

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