Joint Replacement Arthroplasty: Is It Ever Indicated in PIP Joint Fracture-Dislocations?

2016 ◽  
pp. 155-170
Author(s):  
H. L. Baltzer ◽  
Steven L. Moran
Keyword(s):  
Joint Replacement ◽  
Joint Fracture ◽  
Replacement Arthroplasty ◽  
Fracture Dislocations ◽  
Pip Joint

Extension-Block Pinning for Unstable Dorsal Proximal Interphalangeal Joint Fracture-Dislocations: A Simple, Percutaneous Technique With Reproducible Outcomes

Hand ◽  
2022 ◽  
pp. 155894472110663
Author(s):  
Christopher A. Worgul ◽  
Andrew B. Stein
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Kirschner Wire ◽  
Proximal Phalanx ◽  
Treatment Delay ◽  
Joint Fracture ◽  
Fracture Dislocations ◽  
Pip Joint

Background: Proximal interphalangeal (PIP) joint fracture-dislocations can be technically challenging injuries to treat, and no technique has proven to be superior nor lead to predictably good outcomes. We describe our experience of treating unstable dorsal fracture-dislocations of the PIP joint with extension-block pinning (EBP) at our institution over a 22-year period. Methods: In all, 23 patients with 24 unstable dorsal fracture-dislocations of the PIP joint treated with EBP between January 1998 and October 2020 were identified. All patients underwent closed reduction of the PIP joint and insertion of a Kirschner wire into the proximal phalanx, creating a mechanical block. Range of motion and joint congruity were assessed at final clinic follow-up. Long-term function was assessed via completion of a Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. Spearman’s correlation coefficient was utilized to assess if any association existed between treatment delay, pin-in-body days, or amount of articular surface involved and QuickDASH score. Results: Mean range of motion at final follow-up was 83.3° and 22 of 24 PIP joints demonstrated a congruent reduction. In all, 15 of the 23 patients completed the QuickDASH questionnaire at a median long-term follow-up of 57.5 months (range: 3-157 months). Average QuickDASH score was 18.8, indicating minimal long-term disability. No statistically significant associations were found between treatment delay, pin-in-body days, or amount of articular surface involved and QuickDASH score. Conclusions: EBP offers a simple and innovative method to treat a complex injury of the PIP joint. It is technically straightforward and cheap, and produces excellent functional outcomes with minimal long-term disability.

Nonoperative Treatment of Volar PIP Joint Fracture Dislocations

2016 ◽  
pp. 197-210
Author(s):  
Alex J. Ferikes ◽  
Scott W. Rogers ◽  
C. Liam Dwyer ◽  
John D. Lubahn ◽  
Terri L. Wolfe ◽  
...  
Keyword(s):  
Nonoperative Treatment ◽  
Joint Fracture ◽  
Fracture Dislocations ◽  
Pip Joint

A Novel Technique for Dynamic External Fixation of Proximal Interphalangeal Joint Fracture-Dislocations

2020 ◽  
Vol 25 (04) ◽  
pp. 427-433
Author(s):  
Nattawut Sastravaha ◽  
Kanon Limudomporn ◽  
Worasun Taweewuthisub
Keyword(s):  
External Fixation ◽  
Low Cost ◽  
Fracture Dislocation ◽  
Dash Score ◽  
Middle Phalanx ◽  
Shaft Fractures ◽  
Joint Fracture ◽  
Fracture Dislocations ◽  
Pip Joint ◽  
The Mean

Background: The pins and rubbers traction system is widely used to treat unstable proximal interphalangeal (PIP) joint fracture-dislocations. However, dealing with rubber bands can be difficult due to its elasticity and weakness. The purpose of this study was to report the results of an alternative dynamic external fixator technique for unstable PIP joint injuries. Methods: Thirteen patients with acute unstable PIP joint fracture-dislocation (n = 8), pilon fracture (n = 2), or comminuted shaft fractures of a middle phalanx with or without PIP joint extension (n = 3) were enrolled. The alternative fixator used a plastic syringe to maintain distraction force instead of the commonly used rubber bands. Four patients underwent combined open reduction due to unsatisfactory reduction by closed mean. The fixator was removed when there was radiographic evidence of healing. Results: At 6 months after the operation, the mean active ROM of the injured PIP joint was 89° (range, 70–104°), and the mean Quick-DASH score was 9.78 (range, 0–40.9). The mean NRS of pain before fixator removal was 1 (range, 0–4). One patient had a pin tract infection and underwent debridement and fixator removal at 33 days postoperatively. There was no loss of reduction or implant failure in the study. Conclusions: The results were comparable to other dynamic external fixation techniques used for unstable PIP joint fracture-dislocations. The main advantages of this technique were strength of the system, procedure simplicity, the compact design, and relatively low cost. In addition, this technique can also be used in pilon fractures and comminuted shaft fractures of a middle phalanx with or without PIP joint extension.

Joint replacement in patients with consequence of non-reduced hip joint fracture-dislocations

2017 ◽  
Vol 0 (2) ◽  
pp. 78-83
Author(s):  
Volodymyr Filipenko ◽  
Stanislav Bondarenko ◽  
Sergey Khmyzov ◽  
Anatoliy Zhygun ◽  
Anastasia Panchenko
Keyword(s):  
Hip Joint ◽  
Joint Replacement ◽  
Joint Fracture ◽  
Fracture Dislocations

Augmented hamate replacement arthroplasty for fracture-dislocations of the proximal interphalangeal joints in 12 patients

2017 ◽  
Vol 42 (8) ◽  
pp. 799-802 ◽  
Author(s):  
B. P. Thomas ◽  
S. Raveendran ◽  
S. R. Pallapati ◽  
G. A. Anderson
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plate ◽  
Joint Movement ◽  
Level Of Evidence ◽  
Joint Fracture ◽  
Replacement Arthroplasty ◽  
Fracture Dislocations ◽  
The Stability

We report clinical outcomes in 12 patients with hemi-hamate replacement arthroplasty combined with volar plate arthroplasty. The volar plate was reattached using trans-osseous sutures to reconstruct the ligament-box complex after hamate grafting to augment the stability of the proximal interphalangeal joint. Ten patients had improved joint movement from a mean of 14° before surgery to a mean of 77° at a minimum follow-up of 2 years. Grip strength and pain of the affected hand and patient-rated hand and wrist scores were improved in these 10 patients. Two patients had poor results. One patient developed ankylosis, and one patient had resorption of the grafted bone. We conclude that the augmented hamate replacement arthroplasty is useful in treating chronic proximal interphalangeal joint fracture-dislocations. Level of evidence: IV

Hemi-hamate Autograft Arthroplasty for Acute and Chronic PIP Joint Fracture Dislocations

2013 ◽  
Vol 45 (01) ◽  
pp. 13-19 ◽  
Author(s):  
N. Lindenblatt ◽  
A. Biraima ◽  
I. Tami ◽  
P. Giovanoli ◽  
M. Calcagni
Keyword(s):  
Joint Fracture ◽  
Fracture Dislocations ◽  
Pip Joint
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