Dorsal Fracture Dislocation of the Proximal Interphalangeal Joint

Staged External Fixation for Chronic Fracture-Dislocation of the Proximal Interphalangeal Joint: Outcomes of Patients With a Minimum 2-Year Follow-Up

“…Reduction of the joint and concentric motion of the injured PIP joint are the most important aspects of long-term recovery. 9 We fully concur with this view. If the injured PIP joint is allowed to undergo concentric motion, the inaccuracy of joint surface restoration (residual articular stepoff or gap, or central fragment depression) associated with the presence of degenerative changes on radiographs in the early stage appears to be ameliorated clinically as well as radiographically after the application of dynamic traction techniques.…”

Factors Affecting the Functional Results of Open Reduction and Internal Fixation for Fracture-Dislocations of the Proximal Interphalangeal Joint

“…2 We feel that open reduction of the palmar fragment is necessary to prevent the recurrence of subluxation by a buttress effect. In addition, restoring the articular surface may prevent secondary osteoarthrosis.…”

“…Most reviews of PIP joint fracturedislocation treatment have emphasised reduction of PIP joint subluxation and restoration of articular congruity, which ensures normal gliding of the base of the middle phalanx around the head of the proximal phalanx. [1][2][3] In this regard, various surgical techniques have been proposed, yielding equivalent results. Although open reduction and internal fixation (ORIF), as reported by Wilson and Rowland,4 is the treatment of choice for restoring accurate PIP joint congruity, it has not been popular because of its soft tissue invasiveness and technically demanding nature.…”

Hemi-Hamate Autograft for the Treatment of Unstable Dorsal Fracture Dislocation of the Proximal Interphalangeal Joint

“…Failure to restore the gliding motion of the PIP joint necessary for normal function remains a risk of many suggested methods, particularly when the middle phalangeal base fracture is comminuted, or when treatment is delayed. 1 The technique of hemi-hamate autografting provides another option in these challenging clinical circumstances.…”

“…There is little high-level evidence available to guide the clinician in choosing among the numerous available therapeutic alternatives, although there is general agreement that restoration of the normal gliding motion of the base of the middle phalanx about the head of the proximal phalanx is required for a successful outcome. 1 The available literature suggests that modest articular surface irregularity or minor dorsal displacement of the longitudinal axis of the middle phalanx relative to that of the proximal phalanx is generally well-tolerated so long as the base of the middle phalanx does not hinge or pivot on the head of the proximal phalanx. 2,3 A recent study has demonstrated that restoration of the osseous anatomy of the palmar base of the middle phalanx is the necessary and sufficient condition for recovering PIP joint stability and normal joint glide (Hamlet WP, Hastings H Jr.…”