The use of dynamic external fixation in the treatment of dorsal fracture subluxations and pilon fractures of finger proximal interphalangeal joints

2016 ◽  
Vol 42 (2) ◽  
pp. 182-187 ◽  
Author(s):  
M. M. Abou Elatta ◽  
F. Assal ◽  
H. M. Basheer ◽  
A. F. El Morshidy ◽  
S. M. Elglaind ◽  
...  
Keyword(s):  
Early Mobilization ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Motion ◽  
Stable Fixation ◽  
Level Of Evidence ◽  
The Mean ◽  
Finger Motion ◽  
Pilon Fractures

The aim of this study was to review the outcome of the treatment of finger proximal interphalangeal joint dorsal fracture subluxations and pilon fractures with a modified external fixator. We treated 36 patients (36 fingers). We assessed the ranges of motion and patient satisfaction. At final follow-up, 23 patients had no pain; 11 had pain in the cold; and two also had mild pain. None had moderate or severe pain. The mean range of proximal interphalangeal joint motion was 86° (60°–100°). The mean total active range of finger motion was 244° (range 200°–265°). This system is simple, cheap and relatively easily applied. It gives stable fixation that allows early mobilization. Level of evidence: IV

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

Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts

2016 ◽  
Vol 42 (2) ◽  
pp. 188-193 ◽  
Author(s):  
M. Burnier ◽  
T. Awada ◽  
F. Marin Braun ◽  
P. Rostoucher ◽  
M. Ninou ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Pinch Strength ◽  
Middle Phalanx ◽  
Level Of Evidence ◽  
Active Flexion ◽  
The Mean

The primary aim of this study was to assess the clinical and radiological results after hemi-hamate resurfacing arthroplasty in patients with acute or chronic unstable fractures of the base of the middle phalanx and to describe technical features that can facilitate the surgical procedure. Hemi-hamate arthroplasties were done in 19 patients (mean age 39 years) with an isolated fracture at the base of the middle phalanx that involved more than 40% of the articular surface. We assessed ten chronic cases (treated >6 weeks after fracture) and nine acute ones (<6 weeks) at a mean of 24 months. Pain scores, QuickDASH scores, grip strengths, range of motion and radiological findings were recorded at follow-up. At follow-up, the mean active flexion at the proximal interphalangeal joint was to 83° with a mean fixed flexion of 17° (active range of motion 66°). The mean active distal interphalangeal motion was 41°. The mean visual analogue scale score was 1.1. The mean QuickDASH score was 11. The mean pinch strength was 82% of the opposite side. Radiographs revealed one partial graft lysis. Level of evidence: IV

Proximal interphalangeal joint arthroplasty with silicone implants (NeuFlex) by a lateral approach: a series of 51 cases

2011 ◽  
Vol 37 (1) ◽  
pp. 50-55 ◽  
Author(s):  
M. Merle ◽  
F. Villani ◽  
B. Lallemand ◽  
L. Vaienti
Keyword(s):  
Lateral Approach ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Silicone Implants ◽  
Lateral Stability ◽  
Degenerative Osteoarthritis ◽  
The Mean ◽  
Quick Dash

The aim of this study is to assess outcomes of a lateral surgical approach for proximal interphalangeal joint arthroplasty with NeuFlex® silicone implants for primary degenerative osteoarthritis. We reviewed 51 arthroplasties performed on 43 patients. The mean follow up period was 36 months (range 18–42). The average preoperative range of motion (ROM) was 38°. The average postoperative ROM was 63°. In 21/51 (41%) cases, there was an average axial deviation of 17° (range 10–30°). VAS and Quick DASH scores improved. In 5/51 (10%) cases, further surgery was required. Our lateral approach seems to be effective and minimally invasive, providing adequate exposure. Contralateral incision and contralateral ligament reinforcement should be performed, whenever necessary, to improve lateral stability.

Fractures of the Phalanges: Results of Internal Fixation Using 1.5mm and 2mm A. O. Screws

1987 ◽  
Vol 12 (1) ◽  
pp. 28-33
Author(s):  
D. J. FORD ◽  
S. EL-HADIDI ◽  
P. G. LUNN ◽  
F. D. BURKE
Keyword(s):  
Internal Fixation ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Active Movement ◽  
Flexion Deformity ◽  
The Mean ◽  
Condylar Fractures ◽  
Phalangeal Fractures ◽  
Mean Time

Thirty-six patients were treated for 38 phalangeal fractures using 1.5 mm and 2 mm A. O. screws. Plates were not used in the fingers. Oblique fractures of the condyles, shafts or bases of the proximal or middle phalanges were treated by internal fixation because of instability, displacement or rotation. 40% of fractures had associated skin wounds, were comminuted or had damage to the extensor mechanism. The mean duration of post-operative immobilization was 9 days and the mean time off work was 6 weeks. Total active movement in the involved ray was 220 degrees or greater in 24 cases, 180 degrees to 215 degrees in eight cases, and less than 180 degrees in two patients at follow up. The patients were reviewed between three and 54 months after treatment and the mean duration of follow up was 24 months. The most frequent complication was 10 degrees to 30 degrees of flexion deformity of the proximal interphalangeal joint after internal fixation of condylar fractures. Results were satisfactory in 90% of cases.

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

MatOrtho proximal interphalangeal joint arthroplasty: minimum 2-year follow-up

2016 ◽  
Vol 41 (9) ◽  
pp. 910-916 ◽  
Author(s):  
O. Flannery ◽  
O. Harley ◽  
R. Badge ◽  
A. Birch ◽  
D. Nuttall ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Cobalt Chromium ◽  
Retrospective Case ◽  
Replacement Arthroplasty ◽  
Functional Scores ◽  
The Mean

The MatOrtho proximal interphalangeal replacement is a cementless cobalt–chromium metal-on-polyethylene mobile-bearing surface replacement arthroplasty. The aim of this study is to report the outcome and complications of this implant at a minimum of 2 years follow-up from a single institution. A retrospective case review was performed on all MatOrtho proximal interphalangeal joint replacements performed with a minimum of 2 years follow-up. Patient demographics, diagnosis, implant revision and other surgical interventions were recorded. Subjective and objective outcomes were evaluated at latest follow-up, including pain scores, range of motion, function and radiographic assessment. A total of 109 implants were inserted in 56 patients. Nine implants (six patients) were lost to follow-up. Of the remaining 100 implants, 75 had been undertaken in females. The mean age at time of surgery was 64 years and the principal diagnosis was osteoarthritis in 74%. The mean follow-up was 47 months (range 24–77). Within the group there was a statistically significant diminution in pain. There was also an improvement in functional scores post-operatively. Improvement in range of motion was seen in those joints with a pre-operative range of motion greater than 20°. Radiologically there was no evidence of loosening or of implant subsidence at final follow-up. The revision rate was 13%. Nine joints were revised to the NeuFlex (silicone rubber) prosthesis, three were converted to an arthrodesis and one had exchange of the MatOrtho prosthesis. The survival of the MatOrtho proximal interphalangeal joint arthroplasty was 85% at a minimum of 2-years follow-up. Patients can be advised that the procedure achieves good pain relief, improvement in functional scores and may improve range of motion. We would, however, caution against this implant’s use in joints that are either stiff or have significant deformity and/or instability pre-operatively.

Long-term results of single-stage reduction surgery for the treatment of macrodactyly

2016 ◽  
Vol 42 (1) ◽  
pp. 45-50 ◽  
Author(s):  
H.-J. Lee ◽  
P.-T. Kim ◽  
S.-J. Lee ◽  
H.-J. Kim ◽  
I.-H. Jeon ◽  
...  
Keyword(s):  
Corrective Osteotomy ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Single Stage ◽  
Long Term Results ◽  
Reduction Procedure ◽  
Level Of Evidence ◽  
Distal Interphalangeal ◽  
The Mean

We report the long-term results of a single-stage reduction procedure for the treatment of macrodactyly. Six patients (eight cases) were included. These patients underwent a single-stage operation that included debulking with resection of the hypertrophied digital nerve and distal interphalangeal joint fusion or corrective osteotomy. Plain radiographs and functional parameters were assessed. Aesthetic improvement was achieved in all patients. The mean ratios of the lengths and circumference differences between the affected digit and the corresponding normal digit on the other hand were 1:1 and 1:1, respectively. The mean range of motion in the proximal interphalangeal joint was 76°. A sensory deficit in the lateral pulp of the distal phalangeal area was observed in three fingers. The Disabilities of the Arm, Shoulder and Hand score ranged from 0 to 9 (mean 4). The long-term results of the single-stage reduction procedure were satisfactory, as demonstrated by the excellent adjustment of the length and acceptable circumference of the affected digits. Level of evidence: IV

Treatment of fracture subluxations of the proximal interphalangeal joint using a ligamentotaxis device: a multidisciplinary approach

2015 ◽  
Vol 40 (8) ◽  
pp. 825-831 ◽  
Author(s):  
R. J. MacFarlane ◽  
S. Gillespie ◽  
F. Cashin ◽  
A. Mahmood ◽  
G. Cheung ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Outcome Variable ◽  
Postoperative Rehabilitation ◽  
Joint Range Of Motion ◽  
The Mean ◽  
Joint Range ◽  
Mean Time

Complex fracture subluxations of the proximal interphalangeal joint are often difficult to treat and their outcome variable. A number of methods for treatment of these injuries have been described. We have used a ligamentotaxis device ( Ligamentotaxor, Arex, Palaiseau Cedex, France) since 2008. We performed 28 operations in 28 patients with complex proximal interphalangeal joint injuries over a 3-year period. Patients followed a standardized postoperative rehabilitation regime, including fixator adjustment as necessary. The mean age was 33 years (range 18–67). The mean time to surgery was 7 days. At final follow-up (mean 22 months, range 6–52) the mean proximal interphalangeal joint range of motion was 85° (range 60°–110°). The mean QuickDASH functional outcome score was 4.8 (range 0–36.4). Our results compare favourably with other devices reported in the literature.

Dynamic External Fixator for Pilon Fractures of the Proximal Interphalangeal Joints: A Simple Fixator for A Complex Fracture

2003 ◽  
Vol 28 (2) ◽  
pp. 137-141 ◽  
Author(s):  
A. A. SYED ◽  
M. AGARWAL ◽  
R. BOOME
Keyword(s):  
Patient Satisfaction ◽  
Range Of Motion ◽  
External Fixator ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
High Patient Satisfaction ◽  
Complex Fracture ◽  
Effective Dynamic ◽  
Pilon Fractures

We describe a very cheap, simple and effective dynamic external fixator for treatment of pilon fractures of the proximal interphalangeal joint. At final follow-up, nine such fractures had regained an average range of motion of 79° (range, 65–90°). There was high patient satisfaction and there were no serious complications.

Open surgery versus nonoperative treatments for paediatric trigger thumb: a systematic review

2014 ◽  
Vol 39 (7) ◽  
pp. 719-726 ◽  
Author(s):  
S. Farr ◽  
F. Grill ◽  
R. Ganger ◽  
W. Girsch
Keyword(s):  
Systematic Review ◽  
Open Surgery ◽  
Nonoperative Treatment ◽  
Joint Motion ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Trigger Thumb ◽  
The Mean ◽  
Results Of Surgery

The purpose of this systematic review was to determine the outcome of interphalangeal (IP) joint motion in children undergoing open surgical release, splinting, and passive exercising therapy for the treatment of paediatric trigger thumb. We conducted an online literature search of seven major databases. Only studies with a mean follow-up of at least 12 months were considered for inclusion. Seventeen retrospective studies and one prospective study met all the inclusion criteria. They reported on the results of surgery (634 children, 759 thumbs), splinting (115 children, 138 thumbs), and passive exercising (89 children, 108 thumbs). The mean follow-up periods were 59 (surgery), 23 (splinting), and 76 months (exercising), respectively. Full IP joint motion without residual triggering was achieved in 95% of all children undergoing surgery, in 67% of children treated with continuous splinting, and 55% after passive exercising. Based on the low level of evidence available, it seems that open surgery resulted in more reliable and rapid outcomes compared with nonoperative treatment.

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