Proximodistal interphalangeal arthrodesis of the little finger: A series of 7 cases

Honecker, Sophie; Díaz, J.J. Hidalgo; Naïto, Kiyohito; Pire, E.; Prunières, Guillaume; Facca, S.; Liverneaux, P.

doi:10.1016/j.hansur.2016.06.003

Cited by 8 publications

(8 citation statements)

References 11 publications

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“…Excision of the middle phalanx is an alternative technique to correct the PIP joint contracture and aid fusion. It has been reported in 40 patients with successful union but 33% had cold intolerance and 11% sensory loss (Honecker et al., 2016; Raimbeau et al., 2019). This technique results in significant shortening of the finger, which could cause functional problems.…”

Section: Discussionmentioning

confidence: 98%

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Outcome of arthrodesis for severe recurrent proximal interphalangeal joint contractures in Dupuytren’s disease

Bolt

Giele

McNab

et al. 2020

J Hand Surg Eur Vol

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We report long-term outcomes of proximal interphalangeal joint arthrodesis for treatment of severe recurrent joint contractures secondary to Dupuytren’s disease. The patients had at least two previous procedures for Dupuytren’s contracture that involved the same joint, before undergoing joint fusion. Patient demographics, satisfaction, functional outcome, complications, revision and re-operation rates are reported. Eleven patients were included with a mean age of 64 years (range 53–73). The mean proximal interphalangeal joint contracture at presentation was 102° (range 80°–120°). None required revision surgery at a mean of 8 years and 9 months (range 9–199 months). All patients were able to perform their activities of daily living and would recommend this operation to family and friends. This series shows that proximal interphalangeal joint arthrodesis combined with needle fasciotomy or segmental fasciectomy provides a satisfactory salvage procedure in cases of severe recurrent Dupuytren’s disease. Level of evidence: IV

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Section: Discussionmentioning

confidence: 98%

“…We had no cases of nonunion. This could be attributed to the small number of patients, but nonunion of the PIP joint does not appear to be a significant problem in patients with Dupuytren’s disease independent of the technique used (Honecker et al., 2016; Watson and Lovallo, 1987).…”

Section: Discussionmentioning

confidence: 98%

Outcome of arthrodesis for severe recurrent proximal interphalangeal joint contractures in Dupuytren’s disease

Bolt

Giele

McNab

et al. 2020

J Hand Surg Eur Vol

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“…In the single case of simple excision of the middle phalanx in a patient with recurrent Dupuytren contracture, Teboul et al [14] reported that good outcome was achieved at 12 months follow-up, with good grip strength (37 kg measured with Jamar, no information is given on contralateral strength), a finger pulp-palm distance of 1 cm, and return to manual work 6 weeks postoperatively. Honecker et al [13] performed middle phalanx resection with proximodistal fusion in 7 patients, including 4 patients with Dupuytren contracture and reported, at mean follow up was 35 months, significant reduction of pain (from a mean 5.4 preoperatively to 1.4 postoperatively on a 0–10 scale) and improved 11-item disabilities of the arm, shoulder and hand (QuickDASH) score (51 preoperatively to 33 postoperatively). However, 3 of the patients had posttraumatic conditions and one of the patients with Dupuytren’s contracture had rapid recurrence of the disease and bending of the screw-pin.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, this procedure has not been described previously although the underlying concept, removal of the middle phalanx, has been reported in 2 previous publications. Honecker et al described a procedure in which the middle phalanx of the small finger is removed followed by fusion of the proximal and distal phalanx in 7 patients with DD or posttraumatic PIP joint contracture [13]. Teboul et al has described a procedure, done on a patient with recurrent Dupuytren contracture of the small finger after two previous subtotal fasciectomy procedures, involving simple removal of the middle phalanx but without the ligament reconstruction necessary to create a functioning interphalangeal joint [14].…”

Section: Introductionmentioning

confidence: 99%

A new finger-preserving procedure as an alternative to amputation in recurrent severe Dupuytren contracture of the small finger

Eiriksdottir

Atroshi

2019

BMC Musculoskelet Disord

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Background Recurrent severe Dupuytren contracture of the small finger’s proximal interphalangeal (PIP) joint is a difficult problem. Further surgery carries high risk of complications and poor outcome. Patients are often offered finger amputation. We have devised a novel surgical procedure consisting of middle phalanx monoblock resection and ligament reconstruction to create a new functioning interphalangeal joint. Methods Two patients requesting small-finger amputation because of severe PIP joint contracture after multiple treatments for Dupuytren contracture were offered and accepted this new procedure. Through a dorsal incision the extensor tendon is incised longitudinally exposing the middle phalanx and interphalangeal joints. The collateral ligaments of both interphalangeal joints are detached from the middle phalanx. The middle phalanx is dissected from soft tissues (including the flexor digitorum superficialis tendon) and removed. The distal phalanx is brought proximally and the ends of the collateral ligaments are sutured with non-absorbable sutures with the joint held in full extension and congruency. The two patients were evaluated at 18 months and 15 months after surgery, respectively. Results Both patients regained good finger posture with almost full extension and had normal sensation and no pain. Active flexion in the new interphalangeal joint was 60 degrees and 35 degrees, respectively. Both patients had full metacarpophalangeal joint flexion and extension, normal 2-point discrimination in the small finger and higher grip strength in the treated than the contralateral hand. Radiographs showed a congruent new interphalangeal joint. Both patients were very satisfied with the outcome. Conclusions In patients with Dupuytren disease and severe PIP joint contracture after multiple treatments, this novel procedure consisting of middle-phalanx excision and ligament reconstruction creating a new functioning interphalangeal joint has good short-term outcomes and is a favorable alternative to finger amputation. Longer follow-up will show whether these results are durable.

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“…The focus on PIP joint arthrodesis alone excluded other similar interventions, such as arthrodesis of the proximal and distal phalanges with complete middle phalanx resection. 26 Further prospective studies with greater homogeneity in the presentation of results and better-defined measurement methods will increase the quality of future research. In addition, they will enable comparisons with other therapeutic alternatives.…”

Section: Limitationsmentioning

confidence: 99%

Artrodesis de articulación interfalángica proximal en enfermedad de Dupuytren: Una revisión sistemática cualitativa

García

González

et al. 2022

Revista Iberoamericana de Cirugía de la Mano

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Resumen Introducción La enfermedad de Dupuytren (ED) se caracteriza por una alta tendencia a la recidiva. Las reintervenciones asocian elevado riesgo de complicaciones, incrementado tras cada cirugía. En contracturas graves y recidivantes, con insuficiencia vascular o mala calidad tisular, nuevas fasciectomías pueden estar contraindicadas por el riesgo de comprometer gravemente la viabilidad cutánea. En estos casos, artrodesar la articulación interfalángica proximal (IFP) es una alternativa a la amputación. La artrodesis también es una alternativa en aquellas contracturas que asocien artrosis o artrofibrosis de la articulación IFP. El limitado conocimiento sobre esta intervención se justifica por su escasa frecuencia. Realizamos una revisión sistemática cualitativa de resultados y complicaciones de artrodesis de la articulación IFP del segundo al quinto dedos en adultos con ED. Materiales y Métodos Según la declaración de los Ítems Preferidos de Reporte para Revisiones Sistemáticas y Metanálisis (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA, en inglés), desarrollamos una búsqueda en las bases de datos PubMed, Embase y Cochrane Library. Evaluamos el riesgo de sesgo mediante la Escala de Newcastle-Ottawa modificada. Junto a variables intra y preoperatorias y complicaciones, se registró las mejorías funcional y del dolor, y el grado de satisfacción. Resultados Para esta revisión sistemática, se seleccionaron 4 series de casos, con 65 pacientes y 71 artrodesis. No evidenciamos mejorías significativas en términos de dolor o funcionalidad, pero sí un alto grado de satisfacción en todos los estudios. El 11,3% de las complicaciones incluyó una necrosis cutánea, pero ninguna lesión vascular o nerviosa. Conclusión Pese a no demostrar mejoría en dolor o funcionalidad, este procedimiento asocia alto grado de satisfacción y muy baja tasa de afectación cutánea o de lesiones vasculares o nerviosas. El nivel de evidencia sobre resultados y complicaciones es bajo.

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Proximodistal interphalangeal arthrodesis of the little finger: A series of 7 cases

Cited by 8 publications

References 11 publications

Outcome of arthrodesis for severe recurrent proximal interphalangeal joint contractures in Dupuytren’s disease

Outcome of arthrodesis for severe recurrent proximal interphalangeal joint contractures in Dupuytren’s disease

A new finger-preserving procedure as an alternative to amputation in recurrent severe Dupuytren contracture of the small finger

Artrodesis de articulación interfalángica proximal en enfermedad de Dupuytren: Una revisión sistemática cualitativa

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