Injuries Around the Proximal Interphalangeal Joint

Tan, Ruth En Si; Cheah, Andre Eu-Jin

doi:10.1016/j.cps.2019.03.005

Cited by 8 publications

(8 citation statements)

References 93 publications

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“…For comminuted fractures of the MPx base, timetested operations include volar plate and hemi-hamate arthroplasties. 1,3 However, for uncommon, comminuted fractures of the PPx head (London type III) 5,6 no specific treatment protocols exist. A surgery that provides painless, free movement of a joint, any day surpasses arthrodesis, which functionally reduces pinch aperture, strength, and coordination between all the fingers, required for daily function, 7 especially significant in younger patients.…”

Section: Discussionmentioning

confidence: 99%

Volar Plate Draping (VPD) for Severely Comminuted Proximal Phalanx Head Fractures

Varadha Rajan,

Varadharajan,

Bhardwaj

et al. 2024

Indian J Plast Surg

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While proximal phalangeal joint injuries with comminution of the base of the middle phalanx are common injuries, proximal interphalangeal (PIP) joint fracture dislocations with an intact base of middle phalanx and a comminuted head of proximal phalanx are rare. Volar plate arthroplasty and other described techniques prevail for the former injury, while the latter does not have any supportive literature on the exact method of management. We herein present a 20-year-old male with a severely comminuted head of proximal phalanx fracture with dislocation of the PIP joint, which was not reconstructable but was managed successfully with a novel technique of volar plate draping that resurfaced the raw phalangeal head. A 3-year follow-up of the patient, whose finger has full, painless, and complete functional range of movement, gives us the belief that this procedure can provide a fully functional finger where other methods fail to do so.

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Section: Discussionmentioning

confidence: 99%

Volar Plate Draping (VPD) for Severely Comminuted Proximal Phalanx Head Fractures

Varadha Rajan,

Varadharajan,

Bhardwaj

et al. 2024

Indian J Plast Surg

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“…A real-time fluoroscopy stress test can be used to determine the stability of such fracture-dislocations and is an excellent tool if available in the office. Clinicians should look for a dorsal ‘V’ sign on the lateral radiograph of the PIP joint, which is pathognomonic for an incongruent, subluxed PIP joint (Tan and Cheah, 2019) (Figure 2). Other descriptions of the radiographic appearance of this bony relationship include a ‘rose thorn’ sign, which has a more curvilinear shape.…”

Section: Injury Presentationmentioning

confidence: 99%

Proximal interphalangeal joint dislocations and fracture-dislocations

Kolovich,

Heifner

2023

J Hand Surg Eur Vol

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Although proximal interphalangeal joint dislocations are generally straightforward to treat, fracture-dislocations are among the most difficult hand injuries to manage. Fracture patterns range from simple to treat palmar plate avulsion fractures to complex, unstable pilon fractures of the base of the middle phalanx, where achieving adequate reduction and fixation can be extremely difficult. Moreover, these fractures may present sub-acutely or chronically, which greatly adds to the complexity of the case. It is therefore no surprise that clinical results vary and are often difficult to predict. We will discuss the clinical presentations, the various dislocation and fracture-dislocation patterns, treatment options and the complications of these injuries.

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“…If a fracture dislocation with the volar fragment involves more than 30% to 50% of the volar articular surface of the middle phalanx, the buttressing effect of the volar margin and ligamentous support are lost. In this case, fracture dislocation becomes unstable and operative treatment is usually required 5…”

Section: Anatomymentioning

confidence: 99%

“…The visualization of articular incongruency and impaction is better seen in a CT scan preferably with 0.5-mm to 1-mm cuts 4. Dorsal subluxations/dislocation, volar subluxations/dislocation, and pilon fractures are the 3 main types of intra-articular fractures involving the base of middle phalanx 5. A pilon fracture of the PIP joint is a fairly rare, comminuted, and centrally depressed fracture of the base of middle phalanx 6.…”

mentioning

confidence: 99%

“…4 Dorsal subluxations/dislocation, volar subluxations/dislocation, and pilon fractures are the 3 main types of intraarticular fractures involving the base of middle phalanx. 5 A pilon fracture of the PIP joint is a fairly rare, comminuted, and centrally depressed fracture of the base of middle phalanx. 6 The treatment should always be determined on an individual basis and should consider patient age, health, and demands.…”

mentioning

confidence: 99%

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Percutaneous Intramedullary Reduction Technique for Impacted Middle Phalanx Base Fractures

Nordback

Waris²

2021

Techniques in Hand &Amp; Upper Extremity Surgery

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Proximal interphalangeal joint injuries are common and are a major risk for functional deficits of the finger that affect range of motion and grip strength. Impacted intra-articular fractures and fracture dislocations of the middle phalanx base are challenging to treat because of troublesome joint reduction and difficulties in achieving articular congruity. Although treatment algorithms have been published, the anatomically delicate proximal interphalangeal joint often remains incomplete in function and may result in post-traumatic pain, stiffness, and osteoarthritis. This article describes a percutaneous intramedullary reduction technique for impacted middle phalanx fractures as a treatment option to achieve articular congruity with minimal surgical trauma. The reduction technique may be considered for selected patients with impacted fractures of the base of the middle phalanx with or without joint dislocation.

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Injuries Around the Proximal Interphalangeal Joint

Cited by 8 publications

References 93 publications

Volar Plate Draping (VPD) for Severely Comminuted Proximal Phalanx Head Fractures

Volar Plate Draping (VPD) for Severely Comminuted Proximal Phalanx Head Fractures

Proximal interphalangeal joint dislocations and fracture-dislocations

Percutaneous Intramedullary Reduction Technique for Impacted Middle Phalanx Base Fractures

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