A novel technique for proximal interphalangeal joint fracture-dislocations: the second toe middle phalanx osteochondral graft

Abstract

Many different surgical techniques have been used to treat unstable dorsal proximal interphalangeal joint fracture-dislocations. The authors have used the base of the middle phalanx of the second toe base as an alternative autograft to treat this type of injury. This retrospective study assessed the clinical outcomes of this procedure in 11 patients. Range of motion, grip strength, Disability of the Arm, Shoulder and Hand score and donor site morbidity were assessed at regular intervals postoperatively. Nine patients had acute injuries and two had chronic injuries. The mean range of motion in the proximal interphalangeal joint at final review was 65° for patients with acute injuries and 41° for patients with chronic injuries. Other outcomes were satisfactory and there were no complications. Level of evidence: IV

Dorsal Fracture–Dislocations of the Proximal Interphalangeal Joint

“…Some surgeons have even looked to the feet for inspiration to find a better solution for this injury. 7 Further cadaveric and biomechanical studies will allow us to assess contact surface areas and loading characteristics between the distal articular surfaces of the capitate and the proximal phalangeal head. Further consideration should be made to the donor site and the potential consequence on carpal loads, instability, and postoperative pain when choosing the ideal graft.…”