Management of crescent fracture–dislocation of the sacroiliac joint: iliosacral screws versus plate fixation

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MahmoudM Abdel Karim ◽  
AhmedH Abdel-Azeem
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Deepak Samson ◽  
Simon Tan

Background: To evaluate the treatment of severe dorsal fracture dislocation (DFD) injuries of the proximal interphalangeal joint (PIPJ) by open reduction, bone grafting and fixation with mini-hook plates. Methods: Fourteen patients with extensive dorsal fracture dislocation of the PIPJ were operatively treated to reconstruct the fractured middle phalanx volar lip using a fabricated hook plate in conjunction with elevation and bone grafting of depressed articular fragments where present. Results: Restoration of PIPJ articular anatomy and congruence by hook plate fixation permitted full-range mobilization of the joint during fracture healing, with an average arc of motion of 81° and an average loss of extension of 12.9° at a minimum of 6 months follow up. Hook plate treatment of PIPJ fracture dislocation restores articular anatomy and joint congruence at a single sitting and permits post-operative mobilization without the need for extension block splinting. Conclusions: Our results demonstrate a good range of motion following treatment, however hardware removal and tenolysis was necessary in 36% of cases.


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