Early Results of Hemicondylar Hamate Replacement Arthroplasty in Proximal Interphalangeal Fracture-Dislocation Injury

ABSTRACT

PURPOSE: We assessed early clinical and radiological results of hemicondylar hamate replacement arthroplasty in fracture-dislocation injury of the proximal interphalangeal joint. MATERIALS AND METHODS: From March 2007 to February 2008, four patients who had suffered from comminuted unstable fracture-dislocation of the proximal interphalangeal joint were treated by hemicondylar hamate replacement arthroplasty. All patients were male, and average age at operation was 21.5(range, 14~27) years. All cases showed subluxation of the proximal interphalangeal joint, and mean articular surface involvement was 50.8(range, 42.1~62.5)%. We clinically measured ROM, grip strength, pain of donor & recipient site, and radiologically assessed whether or not union, malalignment, or step-off occurred. RESULTS: Average follow-up period was 9.5(range, 6~14) months. Mean flexion contracture was 12.5 (range, 10~15)degrees in affected side and 0degrees in unaffected side. Mean further flexion was 92.5 (range, 85~100)degrees in affected side and 95.0 (range, 90~100)degrees in unaffected side. Mean VAS pain scores was 1.75 (range, 1~3) in recipient site and 1.25 (range, 0~2) in donor site. Mean grip strength was 11 (range, 8~15) lb in affected side and 14 (range, 10~17) lb in unaffected side. Union without malalignment was achieved in all cases. CONCLUSIONS: Early results of hemicondylar hamate replacement arthroplasty in the treatment of fracture-dislocation of the proximal interphalangeal joint showed satisfactory functional and radiological outcome.