Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts

Burnier, Marion; Awada, Tetsuya; Braun, Ferdinand; Rostoucher, P.; Ninou, M.; Erhard, L.

doi:10.1177/1753193416671886

Cited by 31 publications

(30 citation statements)

References 17 publications

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“…To avoid these problems, two important elements are required: preservation of the jointstabilizing complex and initial rigid fixation for early rehabilitation. Most investigators recommend early active motion to prevent tendon adhesion and joint contracture 13 . Immobilization also contributes to joint stiffness 14 and osteoarthritis 15,16 .…”

Section: Discussionmentioning

confidence: 99%

Use of a Costal Osteochondral Graft for Reconstruction of a Proximal Phalanx Head with a Comminuted Fracture of the Proximal Interphalangeal Joint

et al. 2020

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We report the use of costal osteochondral grafting with a pins and rubbers traction system (PRTS) for treatment of a complex cartilage defect of the proximal interphalangeal (PIP) joint in a 41-year-old male carpenter who had inadvertently incompletely severed his finger with a power saw. The skin laceration extended to the dorsal aspect of his ring finger and resulted in incomplete loss of the ulnar condyle and comminution of the radial condyle of the proximal phalanx of the PIP joint. The diagnosis was intraarticular PIP joint open fracture of the left ring finger with a 60% defect of the proximal phalanx joint surface. Three weeks after the injury, PIP joint reconstruction was performed with a costal osteochondral graft harvested at the osteochondral junction of the fifth rib. The volar side of the proximal phalanx cortex and the condyles of the proximal phalanx on each side, which included the origin of the collateral ligaments, were preserved. The graft was shaped to match the defect, and biplane fixation with three miniscrews was subsequently performed. Last, a PRTS was attached. At 6 months postoperatively, the patient returned to his job; at 12 months postoperatively, the joint was stable and free of pain.This technique enabled preservation of joint stabilizers and rigid fixation of the graft, resulting in a good outcome. Our modified costal osteochondral graft with a PRTS is useful for severe intra-articular fractures of the PIP joint and should be considered before salvage procedures. (J Nippon Med Sch 2020; 87: 37 42)

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Section: Discussionmentioning

confidence: 99%

Use of a Costal Osteochondral Graft for Reconstruction of a Proximal Phalanx Head with a Comminuted Fracture of the Proximal Interphalangeal Joint

et al. 2020

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“…There is no universally accepted treatment, however, of unstable fracture dislocations of the PIPJ. 39 In a survey of surgeons using lateral radiographs of the PIPJ, Janssen and colleagues 10 found that there was substantial agreement when deciding for operative versus nonoperative treatment, but there was variation regarding which surgical technique to use for the same fracture. Articular step or gap greater than 2 mm and joint subluxation or dislocation were associated most strongly with a decision for operative treatment.…”

Section: Treatment Of Proximal Interphalangeal Joint Fracture Dislocamentioning

confidence: 99%

“…Reconstruction of the articular surface can be difficult in comminuted fractures, hence the usefulness of a graft. 39 It is more technically demanding than ORIF. Consequently, it may be reasonable to first attempt ORIF and then proceed to HHA when excessive comminution precludes ORIF.…”

Section: Hemi-hamate Replacement Arthroplastymentioning

confidence: 99%

Injuries Around the Proximal Interphalangeal Joint

Tan

Cheah

2019

Clinics in Plastic Surgery

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“…Die funktionellen Ergebnisse des Verfahrens werden in der Literatur einhellig als gut beurteilt [7][8][9][10][11][12][13][14][15][16][17][18] Die eigenen funktionellen Resultate entsprechen den in der Literatur mitgeteilten Ergebnissen. Die beobachtete Gefäßkomplikation in der eigenen Gruppe ist so von keinem anderen Untersucher beobachtet worden und als Einzelfall zu werten, der jedoch zu einem besonders schonenden Umgang mit den Gefäß-Nervenbündeln mahnt.…”

Section: Operationstechnikunclassified

Ergebnisse der Rekonstruktion der Mittelgliedbasis am Finger durch ein osteochondrales Transplantat vom Os hamatum

Pillukat¹,

Kalb²,

Windolf

et al. 2018

Handchir Mikrochir plast Chir

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Bone fusion was achieved in 100 % with restoration of joint congruity in 12 of 13 cases and a slight subluxation in one case. Follow-up was possible in 9 cases after 23 (5-51) months. The average range of motion in the reconstructed joint for extension/flexion was 0/9/73°; grip strength was 82 % of the unaffected side. Five out of 9 patients developed a mild flexion contracture in the PIP joint. The DASH score was 6 (0-33) points, pain at rest was 1 (0-5), and pain at exercise 2 (0-6) on a visual analogue scale from 0-10. All patients were satisfied and willing to undergo the procedure again. According to the literature, reconstruction of the base of the middle phalanx by an osteochondral graft from the hamate bone is a reliable procedure to restore stability and mobility of the joint.

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Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts

Abstract: IV.

Cited by 31 publications

References 17 publications

Use of a Costal Osteochondral Graft for Reconstruction of a Proximal Phalanx Head with a Comminuted Fracture of the Proximal Interphalangeal Joint

Use of a Costal Osteochondral Graft for Reconstruction of a Proximal Phalanx Head with a Comminuted Fracture of the Proximal Interphalangeal Joint

Injuries Around the Proximal Interphalangeal Joint

Ergebnisse der Rekonstruktion der Mittelgliedbasis am Finger durch ein osteochondrales Transplantat vom Os hamatum

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