Modified Transosseous Wiring Technique for Neglected Fracture–Dislocation of the Proximal Interphalangeal Joint
10.4055/cios.2019.11.2.220
- Author:
Hee June KIM
1
;
Hyun Joo LEE
;
Poong Taek KIM
;
Hee Soo KYUNG
;
Ji Won OH
;
Suk Joong LEE
Author Information
1. Department of Orthopaedic Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea. hjleee@knu.ac.kr
- Publication Type:Original Article
- Keywords:
Fracture dislocation;
Proximal interphalangeal joint;
Bone wires;
Extension block
- MeSH:
Arm;
Bone Wires;
Cicatrix;
Curettage;
Debridement;
Dislocations;
Female;
Fingers;
Follow-Up Studies;
Hand;
Humans;
Joints;
Male;
Range of Motion, Articular;
Shoulder
- From:Clinics in Orthopedic Surgery
2019;11(2):220-225
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Fracture–dislocation of the proximal interphalangeal (PIP) joint of the finger is challenging due to the high risk of stiffness. The purpose of this study is to evaluate the clinical and radiological results of a modified transosseous wiring technique for the management of chronic fracture–dislocations of the PIP joint. METHODS: Ten patients (nine men and one woman; mean age, 38.3 years; range, 21 to 69 years) with neglected fracture–dislocation of the PIP joint were included. The mean duration from injury to operation was 14.7 weeks (range, 3 to 66 weeks). The dorsolateral approach and extension block pinning were used to reduce dislocation. After thorough debridement of the scar tissues in the dorsal dead space and the fracture site, the reduction was maintained with transosseous wiring. Radiologic evaluations of bone union and arthritic changes and clinical evaluations (range of motion of the PIP joint and Disabilities of the Arm, Shoulder and Hand [DASH] score) were performed. The mean follow-up period was 12.9 months (range, 12 to 19 months). RESULTS: All patients demonstrated evidence of radiographic healing within a mean healing time of 6 weeks (range, 4 to 10 weeks); however, one had a widened gap and one had an early arthritic change. The mean range of motion in the PIP joint was 81° (range, 50° to 105°). The mean DASH score was 21.6 (range, 7.5 to 35.8). CONCLUSIONS: For chronic fracture–dislocation of the PIP joint, transosseous wiring with direct curettage and optimal bone purchase can provide satisfying outcome.
