We have located links that may give you full text access.
Percutaneous, intramedullary fracture reduction and extension block pinning for dorsal proximal interphalangeal fracture-dislocations.
Journal of Hand Surgery 2010 December
PURPOSE: A percutaneous, intramedullary fracture reduction technique for treatment of unstable dorsal fracture-dislocation of the proximal interphalangeal (PIP) joint is described and the clinical and radiological results are reported.
METHODS: We conducted a retrospective clinical follow-up of 16 patients with 18 dorsal fracture-dislocations of the PIP joint. After closed joint reduction, we used an extension block K-wire to maintain the joint reduction. Impacted volar articular fragments were reduced percutaneously under fluoroscopy control using a pre-bent K-wire inserted through the intramedullary canal of the middle phalanx. The patients initiated passive range of motion exercises immediately after surgery. After a mean of 3 weeks, we removed the extension block K-wire and allowed free mobilization. We examined 13 patients with 15 injured fingers at a mean 5-year follow-up (range, 1-8 y).
RESULTS: Radiographic reduction of the joint dislocation was achieved and maintained. The mean articular step-off decreased from 2.1 mm (range, 1.6-3.1 mm) to 0.5 mm (range, 0.0-1.2 mm). At the final follow-up, active PIP motion averaged 83° (range, 65° to 97°) with a mean flexion contracture of 3° (range, 0° to 15°). The mean visual analog scale score for digit pain was 1/10. The mean Disabilities of the Shoulder, Arm, and Hand score of 4/100 indicated little functional impairment.
CONCLUSIONS: Percutaneous, intramedullary reduction of the impacted volar articular fragments associated with unstable, dorsal fracture-dislocation of the PIP joint restores joint congruence and function.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
METHODS: We conducted a retrospective clinical follow-up of 16 patients with 18 dorsal fracture-dislocations of the PIP joint. After closed joint reduction, we used an extension block K-wire to maintain the joint reduction. Impacted volar articular fragments were reduced percutaneously under fluoroscopy control using a pre-bent K-wire inserted through the intramedullary canal of the middle phalanx. The patients initiated passive range of motion exercises immediately after surgery. After a mean of 3 weeks, we removed the extension block K-wire and allowed free mobilization. We examined 13 patients with 15 injured fingers at a mean 5-year follow-up (range, 1-8 y).
RESULTS: Radiographic reduction of the joint dislocation was achieved and maintained. The mean articular step-off decreased from 2.1 mm (range, 1.6-3.1 mm) to 0.5 mm (range, 0.0-1.2 mm). At the final follow-up, active PIP motion averaged 83° (range, 65° to 97°) with a mean flexion contracture of 3° (range, 0° to 15°). The mean visual analog scale score for digit pain was 1/10. The mean Disabilities of the Shoulder, Arm, and Hand score of 4/100 indicated little functional impairment.
CONCLUSIONS: Percutaneous, intramedullary reduction of the impacted volar articular fragments associated with unstable, dorsal fracture-dislocation of the PIP joint restores joint congruence and function.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app