Unstable Dorsal Fracture-Dislocations of the Proximal Interphalangeal Joint: Volar Plate Fixation with or without Bone Graft

Abstract

Background: To evaluate the treatment of severe dorsal fracture dislocation (DFD) injuries of the proximal interphalangeal joint (PIPJ) by open reduction, bone grafting and fixation with mini-hook plates. Methods: Fourteen patients with extensive dorsal fracture dislocation of the PIPJ were operatively treated to reconstruct the fractured middle phalanx volar lip using a fabricated hook plate in conjunction with elevation and bone grafting of depressed articular fragments where present. Results: Restoration of PIPJ articular anatomy and congruence by hook plate fixation permitted full-range mobilization of the joint during fracture healing, with an average arc of motion of 81° and an average loss of extension of 12.9° at a minimum of 6 months follow up. Hook plate treatment of PIPJ fracture dislocation restores articular anatomy and joint congruence at a single sitting and permits post-operative mobilization without the need for extension block splinting. Conclusions: Our results demonstrate a good range of motion following treatment, however hardware removal and tenolysis was necessary in 36% of cases.

Effect of Silver Nanoparticles With Thermoplastic Polyurethane on Postoperative Rehabilitation of Diabetic Patients With Open Fracture of Lower Extremities

“…There was an expected rise to 366 million individuals with DM by 2030 worldwide; therefore, the incidence of open fractures of the lower limb is also on the rise ( 3 , 4 ). The wounds have the characteristics of foreign body pollution, serious tissue defects, and poor blood supply, which are easily associated with infection, especially in patients with diabetes ( 5 ). If wound infection occurs after fixation surgery, it may lead to delayed healing, multiple debridements, bone and soft tissue defects, and joint stiffness, resulting in permanent loss of function and even amputation ( 6 , 7 ).…”

El falanks kırıklarında açık redüksiyon ve plak ile fiksasyonun sonuçları

“…Falanks kemikleri, küçük kemik olarak sınıflandırılmasına karşın, kırıklarının yarattığı sorunlar büyüktür. Bu kemikler stabilite, dizilim ve hareket arasındaki ince dengenin en keskin şekilde karşımıza çıktığı bölgelerdedir 5,6 . Biomekanik çalışmalar proksimal falanksın kavanoz açma gibi rotasyonel hareketlerde 25 newtona'a yakın bir güç ile karşı karşıya olduğunu göstermişlerdir.…”