Open Reduction and Internal Fixation for Intraarticular Volar Fractures of the Middle Phalanx in Proximal Interphalangeal Joint

PURPOSE: We report clinical and radiographic outcomes after internal fixation of intraarticular volar fractures of the middle phalanx base. METHODS: A retrospective review was conducted on 11 patients who had been treated with miniplate or screw for acute proximal interphalangeal joint fracture, after adjusting for the cases excluding severe comminuted or open fractures. The participants consisted of 9 males and 2 females, with average age of 43.7 years and with average follow-up period of 15.2 months. Bony union, change of articular side were examined through radiographs, and functional results were evaluated by means of the total active range of motion (TAM) and the disabilities of the arm, shoulder, and hand (DASH). RESULTS: Of 11 cases of a finger fracture, 7 cases were fixed by miniplate with screws and 4 cases by screws alone. At the final follow-up retrospection, the average range of proximal interphalangeal joint motion was 95degrees, the average TAM was 243.2degrees, and the average DASH score was 7.4. Average 2.8 months was spent from the finger fracture to bony union. There was no case of degenerative change. CONCLUSION: Open reduction and internal fixation with screws for acute intraarticular fractures of the middle phalanx base showed favorable results in our study and it could be one of recommendable treatment options.

Treatment of Unstable Dorsal Proximal InterphalangealFracture/Dislocation using a Hemi-Hamate Autograft / 대한정형외과학회잡지

PURPOSE: To evaluate clinical and radiology assessments of the treatment outcomes of an unstable dorsal proximal interphalangeal (PIP) fracture and dislocation by hemi-hamate autograft. MATERIALS AND METHODS: Six patients underwent a hemi-hamate autograft for the treatment of an unstable dorsal PIP fracture dislocation of which the articular involvement of the PIP joint was >50%, or an unstable joint despite the lesser degree of involvement. The clinical results were evaluated from the following: postoperative patient satisfaction, range of motion, stability and grip strength. The radiographs were evaluated for the union, and graft incorporation, and/or collapse. RESULTS: All patients were satisfied with the results and the range of motion of the PIP joint was 81 degrees (75-100 degrees). In all cases, stability of the PIP joint was restored. The average grip strength was 82% (75-90%) of the uninjured side. Bone union was achieved in all patients. CONCLUSION: A hemi-hamate autograft is effective for reconstructing the cup-shaped contour of the articular surface, and for recovering the functional range of motion of the PIP joint after an unstable dorsal proximal interphalangeal (PIP) fracture and dislocation. However, more study will be needed through a mid-term and long-term follow up.