Maalla R, Youssef M, Ben Jdidia G, Khimiri C, Essadam H. Extension-block pinning for fracture-dislocation of the proximal interphalangeal joint.
Orthop Traumatol Surg Res 2012;
98:559-63. [PMID:
22884121 DOI:
10.1016/j.otsr.2012.02.009]
[Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 01/27/2012] [Accepted: 02/28/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION
Dorsal fracture-dislocation of the proximal interphalangeal joint is an unstable fracture that associates the anterior marginal fracture of the second phalangeal base and the dorsal dislocation of the proximal interphalangeal joint under the influence of the median band traction of the extensor apparatus. Stiffness and residual pain are frequent sequelae. Treatment involves choosing between the various methods with the objective of providing stable reduction allowing early mobilization.
HYPOTHESIS
We relate our experience concerning treatment by proximal interphalangeal extension-block pinning. It consists in reduction by external manipulation and stabilization by extension-block pinning.
MATERIALS AND METHODS
This technique was used in 22 Trojan-type fractures. The average age of our patients was 36 years, with a predominance of males. In half of the cases, the fracture involved more than 40% of the second phalangeal articular surface.
RESULTS
The mean follow-up in this series was 2 years and 7 months. Assessed based on functional, clinical, and radiological criteria, the results were good in 82% of the cases. The proximal interphalangeal joint was painless and the active mobility sector mean was greater than 85°.
DISCUSSION
The dorsal dislocation fracture of the proximal interphalangeal joint is an unstable lesion. Its treatment must provide stable reduction allowing early mobilization. Various therapeutic means are described. We opted for extension-block pinning, a simple and reproducible technique with encouraging results.
LEVEL OF EVIDENCE
Level IV retrospective study.
Collapse