Surgical Techniques for Correction of Traumatic Hyperextension Instability of the Proximal Interphalangeal Joint: A Biomechanical Study

Micev, Alan J.; Saucedo, James M.; Kalainov, David M.; Wang, Liang; Ma, Madeleine; Yaffe, Mark

doi:10.1016/j.jhsa.2015.05.011

Cited by 6 publications

(2 citation statements)

References 27 publications

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“…Surgery should be adopted either because in some cases the avulsion fracture was large which will influence PIP function, or because in some patients accompanied by lateral collateral ligament rupture, which according to our clinical experience that early surgical treatment is more beneficial. For other conditions, conservative treatment would be more appropriate with a dorsal blocking splint fixation of the PIP at 15° ~ 20° for about 3 weeks in type A and type B, and with a Bedford splint/buddy strapping and early active mobilization in type C. Satisfactory outcome was confirmed in this study during clinical follow-up in both surgically and conservatively treated cases [ 14 – 16 ].…”

Section: Discussionmentioning

confidence: 55%

The role of ultrasonography in diagnosing acute closed volar plate injury of proximal interphalangeal joint

Wang,

Guo,

et al. 2023

BMC Med Imaging

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Background Acute closed volar plate injury of the proximal interphalangeal joint (PIP) is a common hand injury. In the past, there were few objective evaluation imaging methods for the degree of volar plate injury. The purpose of this study was to investigate the role of high frequency ultrasonography in diagnosing volar plate injury, and to explore whether ultrasound can provide a beneficial guidance to clinical decision-making and appropriate treatment adopting through accurate US classification of volar plate injury. Methods From May 2019 to may 2022, 41 patients diagnosed with volar plate injury were included in this study. All patients underwent ultrasonography and X-ray examinations. The sonographic features were analyzed. A new kind of classification of volar plate injury based on ultrasonography findings was described. Results Either an injury of volar plate or an avulsion fracture of middle phalangeal base was identified clearly on ultrasonography, according to which volar plate injury could be divided into three types: A, B and C. Type A, avulsion fracture of the middle phalangeal base without volar plate rupture; Type B, full thickness tear of the volar plate without avulsion fracture; Type C, partial thickness tear of the volar plate. The average thickness of the three types of injured volar plate measured by ultrasound was 0.33 ± 0.05 cm, and the average thickness of the volar plate at the same site of the corresponding finger on the contralateral side was 0.22 ± 0.03 cm. There was significant difference between the two group (t = 11.823, p = 1.2476 *10^(-14)). Conclusions High frequency ultrasonography could be a reliable, accurate, convenient and non-radioactive diagnostic imaging technique in the evaluation of acute closed volar plate injury of PIP. And ultrasound could provide a beneficial guidance to clinical decision-making and appropriate treatment adopting through accurate US classification.

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Section: Discussionmentioning

confidence: 55%

The role of ultrasonography in diagnosing acute closed volar plate injury of proximal interphalangeal joint

Wang,

Guo,

et al. 2023

BMC Med Imaging

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“…Melone et al presented even greater outcomes at 8-year follow up with volar plate repair, with 23 out of 25 patients scoring excellent or good outcomes [ 13 ]. Biomechanical studies have reported inferior outcomes of volar plate reconstruction or repair compared with those of the normal joint, but the surgical techniques do not vary significantly [ 14 ]. Finally, Wollstein et al presented a series of 54 cases treated with volar plate repair on the chronic setting, with favorable outcomes [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of a Neglected Thumb Volar Plate Injury in an 11-Year-Old Girl: A Case Report

Stavropoulos,

Giannatos,

Papathanidis

et al. 2023

Am J Case Rep

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Patient: Female, 11-year-old Final Diagnosis: Volar plate injury Symptoms: Swan-neck deformity Clinical Procedure: — Specialty: Orthopedics and Traumatology Objective: Rare disease Background: Volar plate injuries are rare and difficult to diagnose and treat. Only a few cases have been described on the thumb, especially in children, that resulted in swan-neck type deformity. Conservative treatment has been suggested as first-line management, but surgical reconstruction utilizing flexor digitorum superficialis tenodesis has been described for refractive cases. Only a few attempted surgical repairs of the volar plate have been reported, since it is a technically demanding procedure. Case Report: We present the case of a neglected thumb volar plate injury in an 11-year-old girl after a thumb hyperextension injury. The patient presented 2 months after her injury with functional disability of her thumb. Magnetic resonance imaging had been performed, with no signs of volar plate injury, and she was consequently treated with an extension-blocking splint, with no effect. Clinical examination raised the suspicion of a thumb volar plate injury, which was confirmed during surgical exploration. Therefore, fixation with a bone anchor was performed, and the metacarpophalangeal joint was immobilized in 20° flexion with a percutaneously inserted Kirschner wire. After splinting for 3 weeks, the patient had 10 sessions of physical therapy. At 6-week follow-up, she presented with excellent active and passive range of motion and absence of pain. Conclusions: Magnetic resonance imaging did not have high sensitivity. Six weeks after surgery, full range of motion was achieved, with no stiffness or tenderness at the first metacarpophalangeal joint, suggesting that a thumb volar plate injury had been managed surgically with a suture anchor with excellent results.

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Volar Capsulodesis With Early Active Motion for the Treatment of Chronic Proximal Interphalangeal Joint Hyperextension Deformity

Zaidenberg¹,

Saba²,

Rellán³

et al. 2023

The Journal of Hand Surgery

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Surgical Techniques for Correction of Traumatic Hyperextension Instability of the Proximal Interphalangeal Joint: A Biomechanical Study

Cited by 6 publications

References 27 publications

The role of ultrasonography in diagnosing acute closed volar plate injury of proximal interphalangeal joint

The role of ultrasonography in diagnosing acute closed volar plate injury of proximal interphalangeal joint

Surgical Treatment of a Neglected Thumb Volar Plate Injury in an 11-Year-Old Girl: A Case Report

Volar Capsulodesis With Early Active Motion for the Treatment of Chronic Proximal Interphalangeal Joint Hyperextension Deformity

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