The management of acute fracture dislocations of proximal interphalangeal joints: a systematic review

Breahna, Anca; Mishra, Anuj; Arrowsmith, Jill; Lindau, Tommy

doi:10.1080/2000656x.2020.1788041

Cited by 5 publications

(6 citation statements)

References 24 publications

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“…K-wire external fixators may also be used in combination with ORIF, palmar plate arthroplasty or hemi-hamate arthroplasty (Williams et al, 2003). Breahna et al (2020) carried out a systematic review to compare conservative treatment with surgical intervention for acute isolated PIP fracture-dislocations. Conservative treatment had a significantly higher incidence of secondary arthritic changes and significantly more complications than surgical intervention.…”

Section: Proximal Interphalangeal Joint Fracture-dislocationsmentioning

confidence: 99%

Proximal interphalangeal joint dislocations and fracture-dislocations

Kolovich,

Heifner

2023

J Hand Surg Eur Vol

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Although proximal interphalangeal joint dislocations are generally straightforward to treat, fracture-dislocations are among the most difficult hand injuries to manage. Fracture patterns range from simple to treat palmar plate avulsion fractures to complex, unstable pilon fractures of the base of the middle phalanx, where achieving adequate reduction and fixation can be extremely difficult. Moreover, these fractures may present sub-acutely or chronically, which greatly adds to the complexity of the case. It is therefore no surprise that clinical results vary and are often difficult to predict. We will discuss the clinical presentations, the various dislocation and fracture-dislocation patterns, treatment options and the complications of these injuries.

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Section: Proximal Interphalangeal Joint Fracture-dislocationsmentioning

confidence: 99%

Proximal interphalangeal joint dislocations and fracture-dislocations

Kolovich,

Heifner

2023

J Hand Surg Eur Vol

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“…Various surgical interventions have been described, including transarticular pinning (Newington et al, 2001), extension block pinning (Waris and Alanen, 2010;Waris et al 2016), various dynamic traction systems (Ellis et al, 2007), open reduction and internal fixation with plate or screws (Hamilton et al, 2006;Ikeda et al, 2011;Weiss, 1996) and hemi-hamate arthroplasty (Burnier et al, 2017;Frueh et al, 2015). No method is consistently better than the others (Breahna et al, 2020;Demino et al, 2021;Gianakos et al, 2020). Most of the reported case series have only a small number of patients, and a short-or mid-term follow-up (Breahna et al, 2020;Demino et al, 2021;Gianakos et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…No method is consistently better than the others (Breahna et al, 2020;Demino et al, 2021;Gianakos et al, 2020). Most of the reported case series have only a small number of patients, and a short-or mid-term follow-up (Breahna et al, 2020;Demino et al, 2021;Gianakos et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes after extension block pinning for fracture-dislocations of the proximal interphalangeal joint

Nordback

Westman

Waris

2022

J Hand Surg Eur Vol

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The long-term outcomes of extension block pinning used to treat unstable dorsal fracture-dislocations of the proximal interphalangeal joint have been investigated in a single centre. Thirty-one patients (33 fingers) had a clinical and radiological assessment at a mean follow-up of 16 years. Excluding one joint salvaged with an arthrodesis, the mean active range of motion of the joints was 80° with a mean 5° extension deficit. The mean active range of motion of the distal interphalangeal joint was 64°. The mean Patient-Rated Wrist and Hand Evaluation score was 6, indicating, minimal disability. The mean numeric rating scale for overall subjective pain on a scale of 0–10 was 1 and was not associated with the active range of movement. The Kallman osteoarthritis score and the range of movement of the proximal interphalangeal joint had a negative association. The long-term outcomes were satisfactory and similar to the mid-term follow-up results of the same patient cohort reported 11 years earlier. Level of evidence IV

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“…However, fixation may prove difficult and reconstruction may be favored to avoid chronic pain, osteoarthritis, instability, and limited range of movement (ROM). 2-4…”

Section: Introductionmentioning

confidence: 99%

“…However, fixation may prove difficult and reconstruction may be favored to avoid chronic pain, osteoarthritis, instability, and limited range of movement (ROM). [2][3][4] Hemi-hamate arthroplasty was first suggested by Hastings et al in 1999 5 and involves reconstruction of the volar aspect of the middle phalangeal base with an osteochondral autograft harvested from the distal hamate. A 2015 review of outcomes following HHA suggested that this technique may provide reliable reconstruction of PIPJ fractures.…”

Section: Introductionmentioning

confidence: 99%

Hemi-hamate Arthroplasty for Base of Middle Phalanx Fracture: A Systematic Review

Faulkner

Graham

Hile

et al. 2021

Hand (New York, N,Y.)

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Intra-articular fracture dislocations of the base of the middle phalanx are complex and debilitating injuries that present a management conundrum when nonreconstructable. Hemi-hamate arthroplasty (HHA) is a treatment modality of particular use in the setting of highly comminuted fractures. This systematic review aims to summarize the reported outcomes of HHA in this context. A literature search was conducted using MEDLINE, Embase, and PubMed, yielding 22 studies with 235 patients for inclusion. The weighted mean postoperative range of movement at the proximal interphalangeal joint was 74.3° (range, 62.0°-96.0°) and at the distal interphalangeal joint was 57.0° (range, 14.0°-80.4°). The weighted mean postoperative pain Visual Analog Scale was 1.0 (range, 0.0-2.0). The weighted mean postoperative grip strength was 87.1% (range, 74.5%-95.0%) of the strength on the contralateral side. Posttraumatic arthritis was reported in 18% of cases, graft collapse in 4.2%, and donor site morbidity in 3.0%, with a mean follow-up period of 28.4 months (range, 1-87 months). Hemi-hamate arthroplasty is a reliable and effective technique for the reconstruction of intra-articular base of middle phalangeal fracture dislocations, affording symptomatic relief and functional restoration. Further research is required to assess the true incidence of long-term complications.

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The management of acute fracture dislocations of proximal interphalangeal joints: a systematic review

Cited by 5 publications

References 24 publications

Proximal interphalangeal joint dislocations and fracture-dislocations

Proximal interphalangeal joint dislocations and fracture-dislocations

Long-term outcomes after extension block pinning for fracture-dislocations of the proximal interphalangeal joint

Hemi-hamate Arthroplasty for Base of Middle Phalanx Fracture: A Systematic Review

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