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

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.

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.

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

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

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