Current Trends in the Management of Proximal Interphalangeal Joint Injuries of the Hand

Khouri, Joseph S.; Bloom, Jacob; Hammert, Warren C.

doi:10.1097/prs.0b013e3182a48d65

Cited by 23 publications

(19 citation statements)

References 36 publications

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“…8 Early motion is the most important component of treatment, as prolonged immobilization leads to significant difficulty with stiffness. Although this concept is stressed in most review articles on this subject, 2,9,10 there is little high-level evidence to support this. Arora et al published a retrospective study comparing 4 weeks cast immobilization versus early active motion following reduction of PIPJ dorsolateral dislocations.…”

Section: Dislocations Without Fracturementioning

confidence: 99%

Current Concepts in Treatment of Fracture-Dislocations of the Proximal Interphalangeal Joint

Haase

Chung

2014

Plastic and Reconstructive Surgery

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Background Proximal interphalangeal joint fracture-dislocations are common injuries that require expedient and attentive treatment for the best outcomes. Management can range from protective splinting and early mobilization to complex operations. In this review, the current concepts surrounding the managment of these injuries are reviewed. Methods A literature review was performed of all recent articles pertaining to proximal interphalangeal joint fracture-dislocation, with specific focus on middle phalangeal base fractures. Where appropriate, older articles, or articles on closely related injury types were included for completeness. The methodology and outcomes of each study were analyzed. Results When small avulsion fractures are present, good results are routinely obtained with reduction and early mobilization of stable injuries. Strategies for management of the unstable dorsal fracture-dislocation have evolved over time. To provide early stability, a variety of techniques have evolved, including closed, percutaneous, external, and internal fixation methods. Although each of these techniques can be successful in skilled hands, none have been subjected to rigorous, prospective, comparative trials. Volar dislocations fare less well, with significant loss of motion in many studies. Pilon fractures represent the most complicated injuries, and return of normal motion is not expected. Conclusion The best outcomes can be achieved by (1) establishing enough stability to allow early motion, (2) restoring gliding joint motion rather than non-congruent motion, and (3) restoring the articular surface congruity when possible. Although the majority of literature on this topic consists of expert opinion and retrospective case series, the consensus appears to favor less invasive techniques whenever possible.

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Section: Dislocations Without Fracturementioning

confidence: 99%

Current Concepts in Treatment of Fracture-Dislocations of the Proximal Interphalangeal Joint

Haase

Chung

2014

Plastic and Reconstructive Surgery

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“…A lack of high-level evidence for the assessment and management of hand and finger injuries has been reported elsewhere in the literature. 66,67 Henry hypothesised that perhaps the broad spectrum of variation in fracture patterns and the many associated variables that are thought to affect treatment and outcome may prevent better quality studies such as RCTs from being performed. 66 This may result in a gross underestimation of certain hand injuries, diagnostic error and poor management.…”

Section: Discussionmentioning

confidence: 99%

Review article: Best practice management of closed hand and wrist injuries in the emergency department (part 5 of the musculoskeletal injuries rapid review series)

Strudwick

McPhee

Bell

et al. 2018

Emerg Medicine Australasia

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Acute hand and wrist injuries are a common presentation to the ED and are associated with large individual and societal costs. Appropriate management of these injuries in the ED is crucial given that optimal hand function is essential for daily activities and quality of life. This rapid review investigated best practice for the assessment and management of common closed hand and wrist injuries in the ED. Databases were searched in 2017, including PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites. Primary studies, systematic reviews and guidelines published in English language in the past 12 years that addressed the acute assessment, management, follow-up plan or prognosis were considered for inclusion. Data extraction of included articles was conducted, followed by quality appraisal to rate the level of evidence. The search revealed 2454 articles, of which 55 were included in the review (n = 23 primary articles, n = 26 systematic reviews and n = 6 guidelines). This rapid review provides clinicians who manage common closed fractures and soft tissue injuries of the hand and wrist in the ED, a summary of the best available evidence to enhance the quality of care for optimal patient outcomes. There is evidence to support taking a thorough history and physical examination with consideration of occupational and functional factors, restoring alignment and immobilising when necessary and referring onwards. Key points regarding the diagnosis and management of these injuries are provided.

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“…120°in der sagittalen Ebene (Extensionflexion) ermöglicht. In der axialen und frontalen Ebene sind nur minimale Bewegungsausmaße möglich [6,9]. Die Stabilität des Gelenks wird durch die kongruenten artikulierenden Gelenkflächen erreicht.…”

Section: Anatomieunclassified

“…Die Stabilität des Gelenks wird durch die kongruenten artikulierenden Gelenkflächen erreicht. Der bikondyläre konvexe Kopf der proximalen Phalanx artikuliert mit der bikonkaven Basis der mittleren Phalanx [6]. Diese knöcherne Architektur stabilisiert das Gelenk bei Rotations-oder lateralem Stress [10].…”

Section: Anatomieunclassified

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Fingerluxationen im PIP-Gelenk – Therapie einer sehr häufigen (Ball)Sportverletzung

Müller‐Seubert¹,

Bührer²,

Horch³

2017

Sportverletz Sportschaden

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Fractures or fracture dislocations of the proximal interphalangeal joint often occur during sports or accidents. Dislocations of the PIP-joint are the most common ligamentary injuries of the hand. As this kind of injury is so frequent, hand surgeons and other physicians should be aware of the correct treatment. This paper summarises the most common injury patterns and the correct treatment of PIP-joint dislocations. This paper reviews the current literature and describes the standardised treatment of PIP-joint dislocations. What is most important is that reposition is anatomically correct, and this should be controlled by X-ray examination. Depending on the instability and possible combination with other injuries (e. g. injury to the palmar plate), early functional physiotherapy of the joint or a short immobilisation period is indicated. Early functional treatment of the injured PIP-joint, initially using buddy taping, is important to restore PIP-joint movement and function. Depending on the injury, joint immobilisation using a K-wire may be indicated. Detailed informed consent is necessary to explain to the patient the severity of the injury and possible complications, such as chronic functional disorders or development of arthrosis.

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Current Trends in the Management of Proximal Interphalangeal Joint Injuries of the Hand

Cited by 23 publications

References 36 publications

Current Concepts in Treatment of Fracture-Dislocations of the Proximal Interphalangeal Joint

Current Concepts in Treatment of Fracture-Dislocations of the Proximal Interphalangeal Joint

Review article: Best practice management of closed hand and wrist injuries in the emergency department (part 5 of the musculoskeletal injuries rapid review series)

Fingerluxationen im PIP-Gelenk – Therapie einer sehr häufigen (Ball)Sportverletzung

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