Treatment for Acute Proximal Interphalangeal Joint Fractures and Fracture-Dislocations: A Systematic Review of the Literature

Abstract

Introduction Proximal interphalangeal joint (PIPJ) fractures and fracture-dislocations are common hand injuries and recognition of this injury pattern is essential in the management of these fractures. Although a variety of treatment options have been reported in the literature, the optimal treatment remains controversial. Materials and Methods MEDLINE, EMBASE, and The Cochrane Library Database were screened for treatment strategies of PIPJ fracture and fracture-dislocation. Demographic data and outcome data were collected and recorded. Results A total of 37 studies including 471 patients and 480 fingers were reviewed. PIPJ range of motion (ROM) was greatest postoperatively in patients who underwent volar plate arthroplasty at 90.6 degrees. Dynamic external fixation resulted in the lowest PIP joint ROM with an average of 79.7 degrees. Recurrent pain and osteoarthritis were most often reported in extension block pinning at 38.5 and 46.2%, respectively. Open reduction and internal fixation had the highest rate of revision at 19.7%. Conclusion Overall, the outcomes of PIP fractures and fracture-dislocations are based on the severity of injury, and the necessary treatment required. Closed reduction with percutaneous pinning and volar plate arthroplasty had good clinical and functional outcomes, with the lowest complication rates. Hemi-hamate arthroplasty and dynamic external fixation were utilized in more complex injuries and resulted in the lowest PIPJ ROM. Level of Evidences This is a therapeutic, Level III study.

Treatment of hand and finger fractures with the Stryker Hand Plating System

“…Limits of function are most severe for patients [ 23 ]. Deep infections are rare at around 1% despite the often difficult soft-tissue situation on the fingers [ 24 ], [ 25 ], [ 26 ]. A similar distribution is also reflected in our patient collective with 11.4%.…”

Treatment of Hand and Wrist Fractures with the Stryker Hand Plating System

“…Limits of function are most severe for patients 24 . Deep infections are rare at around 1% despite the often di cult soft-tissue situation on the ngers [25][26][27] . A similar distribution is also re ected in our patient collective with 11.4%.…”

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

“…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).…”

“…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).…”