Open Reduction and Internal Fixation for Intraarticular Volar Fractures of the Middle Phalanx in Proximal Interphalangeal Joint

Ho-Jae Lee; Jin-Hyun Lee; Sun-Tae Bong; Woo-Hyun Kim; Soo-Hong Han

doi:10.12790/jkssh.2014.19.3.116

Journal List > J Korean Soc Surg Hand > v.19(3) > 1106457

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Lee, Lee, Bong, Kim, and Han: Open Reduction and Internal Fixation for Intraarticular Volar Fractures of the Middle Phalanx in Proximal Interphalangeal Joint

ORIGINAL ARTICLE

J Korean Soc Surg Hand 2014;19(3):116-123.

Published online: 11 September 2014

DOI: https://doi.org/10.12790/jkssh.2014.19.3.116

Open Reduction and Internal Fixation for Intraarticular Volar Fractures of the Middle Phalanx in Proximal Interphalangeal Joint

Ho-Jae Lee, Jin-Hyun Lee, Sun-Tae Bong, Woo-Hyun Kim, Soo-Hong Han

Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea

Correspondence to: Soo-Hong Han, Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, School of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam 463-712, Korea, TEL: +82-31-780-5270, FAX: +82-31-780-5944, E-mail: hsoohong@daum.net

Received 3 June 20144 August 2014 Accepted 22 August 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

We report clinical and radiographic outcomes after internal fixation of intraarticular volar fractures of the middle phalanx base.

Methods:

A retrospective review was conducted on 11 patients who had been treated with miniplate or screw for acute proximal interphalangeal joint fracture, after adjusting for the cases excluding severe comminuted or open fractures. The participants consisted of 9 males and 2 females, with average age of 43.7 years and with average follow-up period of 15.2 months. Bony union, change of articular side were examined through radiographs, and functional results were evaluated by means of the total active range of motion (TAM) and the disabilities of the arm, shoulder, and hand (DASH).

Results:

Of 11 cases of a finger fracture, 7 cases were fixed by miniplate with screws and 4 cases by screws alone. At the final follow-up retrospection, the average range of proximal interphalangeal joint motion was 95°, the average TAM was 243.2°, and the average DASH score was 7.4. Average 2.8 months was spent from the finger fracture to bony union. There was no case of degenerative change.

Conclusion:

Open reduction and internal fixation with screws for acute intraarticular fractures of the middle phalanx base showed favorable results in our study and it could be one of recommendable treatment options.

Keywords: Proximal interphalangeal joint, Midphalanx base fracture, Open reduction and internal fixation

REFERENCES

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Fig. 1.

Zigzag skin incisions on the volar side of the finger.

Fig. 2.

The reduction of displaced fracture using a small instrument.

Fig. 3.

(A, B) Internal fixation using miniplate and screws.

Fig. 4.

Proximal phalanx base intraarticular fracture with dorsal subluxation.

Fig. 5.

(A, B) Bony union and articulation with good alignment taken at the follow-up radiographs.

Fig. 6.

(A, B) The postoperative recovery of near-full range of motion.

Fig. 7.

Volar fragment and dorsal subluxation of proximal interphalangea joint with P2 base intraarticular fracture.

Fig. 8.

Open reduction and internal fixation using 2 screws.

Fig. 9.

(A, B) Bony union without degenerative change taken at the follow-up radiographs.

Fig. 10.

(A, B) The postoperative recovery of full range of motion.

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