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

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

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Distraction ligamentotaxis for complex proximal interphalangeal joint fracture dislocations: a clinical study and the modified pins rubber band traction system revisited

Burns & Trauma ◽

10.1186/s41038-018-0124-1 ◽

2018 ◽

Vol 6 ◽

Cited By ~ 2

Author(s):

Cheng Hean Lo ◽

Simone H. Nothdurft ◽

Hye-Sung Park ◽

Eldho Paul ◽

James Leong

Keyword(s):

Range Of Motion ◽

Rating Scale ◽

Rubber Band ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Dash Score ◽

Joint Fracture ◽

Fracture Dislocations ◽

Pin Site ◽

Traction System

Abstract Background The purpose of this study is to present our experience with the modified pins and rubber band traction system, discuss problems encountered, and make recommendations to optimize outcomes. Methods Data was collected prospectively from November 2013 to March 2017 at a tertiary referral hospital in Melbourne, Australia. Patients with closed complex proximal interphalangeal joint fracture dislocations that were considered unsuitable for other surgical options were included in the study. Patients underwent dynamic skeletal distraction using the modified (Deshmukh) pins rubber band traction system. Outcomes were measured using the Nominal Rating Scale for pain; Disabilities of the Arm, Shoulder, and Hand (DASH) score; active and passive range of motion; patient rating scale; and complications. Results Twenty patients underwent the procedure, and 19 were included in analyses. At the final follow-up assessment, an average of 62° and 77° was achieved for proximal interphalangeal joint active and passive range of motion, respectively. Pain levels were low (median score of 0 at rest and 1 ranging, out of 10). Four patients suffered minor pin site infections. Conclusion Distraction ligamentotaxis is a useful part of the armamentarium, especially in the absence of more suitable procedures. It is important to select appropriate patients, educate, and ensure adherence to postoperative therapy. Employing the Deshmukh frame modification streamlines the theatre processes, and removal of wires at approximately 4 weeks minimizes risk of pin site infection.

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Management of Proximal Interphalangeal Joint Fracture Dislocations

Hand Clinics ◽

10.1016/j.hcl.2017.12.005 ◽

2018 ◽

Vol 34 (2) ◽

pp. 149-165 ◽

Cited By ~ 8

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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Internal Fixation of Unstable Fracture Dislocations of the Proximal Interphalangeal Joint

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2005.05.006 ◽

2005 ◽

Vol 30 (5) ◽

pp. 492-498 ◽

Cited By ~ 41

Author(s):

I. GRANT ◽

A. C. BERGER ◽

S. K. Y. THAM

Keyword(s):

Range Of Motion ◽

Early Mobilization ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Unstable Fracture ◽

Group Operation ◽

Chronic Group ◽

Acute Group ◽

Palmar Plate ◽

Fracture Dislocations

We report a group of 14 patients with fracture dislocations of the proximal interphalangeal joint with fracture fragments of adequate size to allow reduction of the proximal interphalangeal joint and internal mini screw fixation of the bone fragment attached to the palmar plate to the base of the middle phalanx. Three years after surgery, (range 25–52 months) the average total active range of motion of the proximal interphalangeal joint was 100° (range 65–115°) for the acute group (operation within 14 days of injury, n = 7) and 86° (range 60–110°) for the chronic group (operation on average 46 days after injury, range 21–120 days, n = 7). Longer delay from injury was associated with a decreased total range of motion ( P = 0.028). Further subluxation occurred in three chronic group patients, one required further surgery. The key to successful treatment of this injury is the re-establishment of joint congruity and early mobilization. With appropriate patient selection, pain free, satisfactory range of motion can be achieved. There is a risk of persistent subluxation or dislocation, particularly if treatment is delayed.

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Modified Hemihamate Arthroplasty Technique for Treatment of Acute Proximal Interphalangeal Joint Fracture-Dislocations

Annals of Plastic Surgery ◽

10.1097/sap.0b013e3182623988 ◽

2014 ◽

Vol 72 (4) ◽

pp. 411-416 ◽

Cited By ~ 23

Author(s):

Dae Suk Yang ◽

Sang Ki Lee ◽

Kap Jung Kim ◽

Won Sik Choy

Keyword(s):

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Joint Fracture ◽

Fracture Dislocations

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

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193414554356 ◽

2014 ◽

Vol 40 (1) ◽

pp. 24-32 ◽

Cited By ~ 25

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

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

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193416671886 ◽

2016 ◽

Vol 42 (2) ◽

pp. 188-193 ◽

Cited By ~ 13

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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