scholarly journals The Comparison of Latero-Medial versus Dorso-Palmar/Plantar Drilling for Cartilage Removal in the Proximal Interphalangeal Joint

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1838
Author(s):  
Alessandro Spadari ◽  
Giulia Forni ◽  
Sara Del Magno ◽  
Claudio Tagliavia ◽  
Marco Canova ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Articular Surface ◽  
Lateral Approach ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Invasive Technique ◽  
Drill Bit ◽  
Dorsal Approach ◽  
Digital Fluoroscopy ◽  
Fluoroscopy Guidance

The aims of the present study were to compare the percentages of articular cartilage removed using a lateral drilling approach of the proximal interphalangeal joint (PIPJ) and a dorsal drilling approach, and to assess the usefulness of digital fluoroscopy when performing a lateral drilling approach. Sixty cadaveric PIPJs were drilled using a surgical drill bit to remove the articular cartilage. The limbs were divided into three groups containing 10 forelimbs and 10 hindlimbs each. One group received the dorsal drilling approach, the second one received the lateral drilling approach and the last one received the lateral drilling approach under digital fluoroscopy guidance. The percentage of articular cartilage removed from each articular surface was assessed using Adobe Photoshop ® software. The percentages of removed cartilage turned out to be significantly higher with lateral approach, especially under fluoroscopic guidance, both in the forelimbs (p = 0.00712) and hindlimbs (p = 0.00962). In conclusion, the lateral drilling approach seems to be a minimally invasive technique with which to perform PIPJ arthrodesis, even more efficient than the previously reported dorsal approach.

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.

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.

Area of cartilage accessible to curettage for subsequent arthrodesis of the equine proximal interphalangeal joint

2013 ◽  
Vol 26 (06) ◽  
pp. 489-492 ◽  
Author(s):  
S. Berchtold ◽  
J. M. Kuemmerle
Keyword(s):  
Articular Cartilage ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Disease ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Contralateral Limb ◽  
Conventional Procedure ◽  
Articular Cartilage Surface ◽  
The Difference

SummaryThis study compared the areas of cartilage accessible for curettage in arthrodesis of the equine proximal interphalangeal joint using the conventional and collateral ligament sparing approaches. For this purpose, forelimbs and hindlimbs of six equine cadavers without radiographic evidence of proximal interphalangeal joint disease were used. One limb of each pair of limbs was randomly assigned to a dissection using a standard approach to the proximal interphalangeal joint including transection of the collateral ligaments, while each contralateral limb was exposed using the same approach but leaving the collateral ligaments intact. Hohmann retractors and Spratt curettes were then used to remove as much articular cartilage as possible. Finally, proximal interphalangeal joints were photographed and image analysis was performed.Using the collateral ligament sparing procedure, the mean percentage of articular cartilage surface removed (41.2%) was significantly less than using the conventional procedure (79.6%) (p <0.01). The difference between forelimbs and hindlimbs was not significant.

scholarly journals Minimally invasive management of dorsiflexion contracture at the metatarsophalangeal joint and plantarflexion contracture at the proximal interphalangeal joint of the fifth toe

2011 ◽  
Vol 1 (2) ◽  
pp. 27
Author(s):  
Mariano De Prado ◽  
Pedro-Luis Ripoll ◽  
Pau Golanó ◽  
Javier Vaquero ◽  
Nicola Maffulli
Keyword(s):  
Minimally Invasive ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Invasive Technique ◽  
Wedge Osteotomy ◽  
Invasive Approach ◽  
Fifth Toe ◽  
Toe Deformity

Several surgical options have been described to manage persistent dorsiflexion contracture at the metatarsophalangeal joint and plantarflexion contracture at the proximal interphalangeal joint of the fifth toe. We describe a minimally invasive technique for the management of this deformity. We perform a plantar closing wedge osteotomy of the 5th toe at the base of its proximal phalanx associated with a lateral condylectomy of the head of the proximal phalanx and at the base of the middle phalanx. Lastly, a complete tenotomy of the deep and superficial flexor tendons and of the tendon of the extensor digitorum longus is undertaken. Correction of cock-up fifth toe deformity is achieved using a minimally invasive approach.

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

The extensor tendon splitting approach to the proximal interphalangeal joint: do we need to reinsert the central slip?

2009 ◽  
Vol 35 (3) ◽  
pp. 188-191 ◽  
Author(s):  
A. M. Afifi ◽  
A. Richards ◽  
A. Medoro ◽  
D. Mercer ◽  
M. Moneim
Keyword(s):  
Extensor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Dorsal Approach ◽  
Pip Joint ◽  
Central Slip ◽  
Extensor Lag

Current approaches to the proximal interphalangeal (PIP) joint have potential complications and limitations. We present a dorsal approach that involves splitting the extensor tendon in the midline, detaching the insertion of the central slip and repairing the extensor tendon without reinserting the tendon into the base of the middle phalanx. A retrospective review of 16 digits that had the approach for a PIP joint arthroplasty with a mean follow up of 23 months found a postoperative PIP active ROM of 61° (range 25–90°). Fourteen digits had no extensor lag, while two digits had an extensor lag of 20° and 25°. This modified approach is fast and simple and does not cause an extensor lag.

scholarly journals A novel dynamic distraction external fixator for proximal interphalangeal joint fracture dislocation

2019 ◽  
Vol 47 (4) ◽  
pp. 1628-1635 ◽  
Author(s):  
Hua-Zhu Wang ◽  
Jian-Yong Zhao ◽  
Zhi-Sheng Zhang
Keyword(s):  
Grip Strength ◽  
External Fixator ◽  
Articular Surface ◽  
Joint Space ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
X Rays ◽  
Joint Fracture ◽  
The Mean

Objective To evaluate the efficacy of a novel dynamic distraction external fixator for proximal interphalangeal joint (PIPJ) fracture-dislocation. Methods From March 2005 to March 2014, 20 patients with PIPJ fracture-dislocation were treated with our technique. Function scores according to the Michigan Hand Outcome Questionnaire (MHQ) score, union time, grip strength, and range of motion (ROM) were recorded before and after treatment. Results All patients completed a mean follow-up of 22 months (range, 12–60 months). All patients achieved fracture union and joint reduction. The mean union time was 3 months (range, 2–6 months). The mean postoperative MHQ score was 88.00 ± 3.42 (range, 84.00–92.00). Postoperative grip strength of the affected sides was 92% of the contralateral sides. X-rays showed that the fracture line disappeared completely with a good joint contour. The range of extension in the PIPJ was −5° (range, −10°–0°). The range of flexion in the PIPJ was 89.40° ± 9.79° (range, 75°–100°). Postoperatively, four patients had slight narrowing of the joint space and two had an uneven articular surface. Pin breakage, loosening, and tract infection were not observed. Conclusions The novel dynamic distraction external fixator is a promising option for PIPJ fracture-dislocation.

Sign in / Sign up

Export Citation Format

Share Document