The hemi-hamate autograft arthroplasty in proximal interphalangeal joint reconstruction: a systematic review

2014 ◽  
Vol 40 (1) ◽  
pp. 24-32 ◽  
Author(s):  
F. S. Frueh ◽  
M. Calcagni ◽  
N. Lindenblatt
Keyword(s):  
Systematic Review ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Joint Involvement ◽  
Level Of Evidence ◽  
Systematic Analysis ◽  
Joint Fracture ◽  
Fracture Dislocations

Palmar lip injuries of the proximal interphalangeal joint with dorsal fracture-dislocation are difficult to treat and often require major reconstruction. A systematic review was performed and yielded 177 articles. Thirteen articles on hemi-hamate autograft were included in full-text analysis. Results of 71 cases were summarized. Mean follow-up was 36 months and mean proximal interphalangeal joint range of motion was 77°. Overall complication rate was around 35%. Up to 50% of the patients showed radiographic signs of osteoarthritis. However, few of those patients complained about pain or impaired finger motion. Based on this systematic analysis and review, hemi-hamate autograft can be considered reliable for the reconstruction of acute and chronic proximal interphalangeal joint fracture-dislocations with joint involvement >50%, but longer-term follow-up studies are required to evaluate its outcome, especially regarding the rate of osteoarthritis. Level of Evidence: II

Augmented hamate replacement arthroplasty for fracture-dislocations of the proximal interphalangeal joints in 12 patients

2017 ◽  
Vol 42 (8) ◽  
pp. 799-802 ◽  
Author(s):  
B. P. Thomas ◽  
S. Raveendran ◽  
S. R. Pallapati ◽  
G. A. Anderson
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plate ◽  
Joint Movement ◽  
Level Of Evidence ◽  
Joint Fracture ◽  
Replacement Arthroplasty ◽  
Fracture Dislocations ◽  
The Stability

We report clinical outcomes in 12 patients with hemi-hamate replacement arthroplasty combined with volar plate arthroplasty. The volar plate was reattached using trans-osseous sutures to reconstruct the ligament-box complex after hamate grafting to augment the stability of the proximal interphalangeal joint. Ten patients had improved joint movement from a mean of 14° before surgery to a mean of 77° at a minimum follow-up of 2 years. Grip strength and pain of the affected hand and patient-rated hand and wrist scores were improved in these 10 patients. Two patients had poor results. One patient developed ankylosis, and one patient had resorption of the grafted bone. We conclude that the augmented hamate replacement arthroplasty is useful in treating chronic proximal interphalangeal joint fracture-dislocations. Level of evidence: IV

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

1998 ◽  
Vol 23 (6) ◽  
pp. 798-801 ◽  
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.

HEMI-HAMATE ARTHROPLASTY VERSUS TRANSARTICULAR KIRSCHNER WIRE FIXATION FOR UNSTABLE DORSAL FRACTURE-DISLOCATION OF THE PROXIMAL INTERPHALANGEAL JOINT IN THE HAND

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 115-119 ◽  
Author(s):  
R. C. Barksfield ◽  
B. Bowden ◽  
A. J. Chojnowski
Keyword(s):  
Bone Grafting ◽  
Kirschner Wire ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Fracture Dislocations ◽  
Fixed Flexion Deformity

Following the introduction of the hemi-hamate arthroplasty (HHA) technique to our unit, we sought to evaluate the early clinical outcomes achieved with this method of fixation and compare these with simple trans-articular Kirschner wire (K-wire) fixation for dorsal fracture dislocations (DFD) of the proximal interphalangeal joint (PIPJ). Ninteen patients underwent fixation of these injuries with either K-wire fixation (12/19) or hemi-hamate bone grafting (7/19) between 2005 and 2011. At a mean follow-up of 14 weeks median arc of movement at the PIPJ was 65° (range 31° to 108°) following HHA and 56° (range 9° to 85°) (p = 0.82) following temporary transarticular K-wire fixation. Median fixed flexion deformity (FFD) was 20° and 15° for hemi-hamate bone grafting and K-wire fixation respectively. Based upon our findings, transarticular K-wire fixation produced equivalent outcomes to HHA for unstable DFD of the PIPJ in the hand.

Treatment of dorsal fracture-dislocations of the proximal interphalangeal joint using the shotgun approach

2018 ◽  
Vol 43 (5) ◽  
pp. 499-505 ◽  
Author(s):  
Farid Najd Mazhar ◽  
Davod Jafari ◽  
Hamid Taraz ◽  
Alireza Mirzaei
Keyword(s):  
Internal Fixation ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Level Of Evidence ◽  
Visual Analogue Pain ◽  
Joint Fracture ◽  
Contralateral Hand ◽  
Fracture Dislocations ◽  
The Mean ◽  
Shotgun Approach

This study assessed the outcome of open reduction and internal fixation of proximal interphalangeal joint fracture-dislocations through a shotgun approach, while keeping hemi-hamate arthroplasty as a back-up plan. After using the shotgun approach, fixation was carried out when the anterior fragment was large enough to accept two 1.5 mm screws. Sixty-three fracture-dislocations were treated in 61 patients, of whom 30 underwent internal fixation. Twenty-one of these were assessed in the final study. At a mean follow-up of 29 months, the mean range of joint motion was 80° and 102° for the injured and contralateral hand, respectively. The mean pinch and grip strengths of injured hand were 82% and 83% of contralateral hand, respectively. The mean disabilities of the arm, shoulder and hand score was 5.5. The mean visual analogue pain score was 1.6. Surgery through the versatile shotgun approach allows excellent intra-operative assessment and acceptable outcomes. Level of evidence: IV

Chronic Fracture Dislocations of the Proximal Interphalangeal Joint

1994 ◽  
Vol 19 (6) ◽  
pp. 783-787 ◽  
Author(s):  
N. R. M. FAHMY ◽  
N. KENNY ◽  
N. KEHOE
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Range Of Movement ◽  
Fracture Dislocations ◽  
Pip Joint ◽  
Phalangeal Fracture

The “S” Quattro has proved its value in the treatment of acute displaced comminuted intraarticular phalangeal fracture dislocations. We have used the system to treat five cases of chronic fracture-dislocation or subluxation of the PIP joint. At an average follow-up period of 16.4 months, there was a mean increase in the range of movement of the injured joint by 75°. We recommend this technique for selected cases.

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

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
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.

Volar plating versus external fixation for unstable dorsal fracture-dislocations of the proximal interphalangeal joint

2021 ◽  
pp. 175319342110593
Author(s):  
Atsuhiko Murayama ◽  
Kentaro Watanabe ◽  
Hideyuki Ota ◽  
Shigeru Kurimoto ◽  
Hitoshi Hirata
Keyword(s):  
External Fixation ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plating ◽  
Distal Interphalangeal Joint ◽  
Active Flexion ◽  
Plate Group ◽  
Fracture Dislocations ◽  
Distal Interphalangeal

We retrospectively compared the results of volar plating and dynamic external fixation for acute unstable dorsal fracture-dislocations of the proximal interphalangeal joint with a depressed fragment. We treated 31 patients (31 fingers), 12 with volar buttress plating and 19 with dynamic external fixation. Follow-up averaged 35 and 40 months in the two groups, with a minimal 6-month follow-up. Average active flexion of the proximal interphalangeal joint was 95° after plate fixation and 87° after external fixation, with an active extension lag of –6° and –9°, respectively. Active flexion at the distal interphalangeal joint averaged 67° in the plate group and 58° in the external fixation group, with active extension lags of 0° and –5°, respectively. We conclude that both methods can obtain a good range of motion at the proximal interphalangeal joint. A limitation of the extension of the distal interphalangeal joint occurred with dynamic external fixation but not with volar buttress plating. Level of evidence: IV

A novel technique for proximal interphalangeal joint fracture-dislocations: the second toe middle phalanx osteochondral graft

2021 ◽  
pp. 175319342110292
Author(s):  
Danielle Nizzero ◽  
Nicholas Tang ◽  
James Leong
Keyword(s):  
Range Of Motion ◽  
Surgical Techniques ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Joint Fracture ◽  
Acute Injuries ◽  
Fracture Dislocations ◽  
Chronic Injuries ◽  
Second Toe

Many different surgical techniques have been used to treat unstable dorsal proximal interphalangeal joint fracture-dislocations. The authors have used the base of the middle phalanx of the second toe base as an alternative autograft to treat this type of injury. This retrospective study assessed the clinical outcomes of this procedure in 11 patients. Range of motion, grip strength, Disability of the Arm, Shoulder and Hand score and donor site morbidity were assessed at regular intervals postoperatively. Nine patients had acute injuries and two had chronic injuries. The mean range of motion in the proximal interphalangeal joint at final review was 65° for patients with acute injuries and 41° for patients with chronic injuries. Other outcomes were satisfactory and there were no complications. Level of evidence: IV

Management of Proximal Interphalangeal Joint Fracture Dislocations

Hand Clinics ◽  
2018 ◽  
Vol 34 (2) ◽  
pp. 149-165 ◽  
Author(s):  
Nicholas M. Caggiano ◽  
Carl M. Harper ◽  
Tamara D. Rozental
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Fracture ◽  
Fracture Dislocations
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