Objectives:
Our aim was to evaluate outcomes of surgical treatment methods (open reduction and internal fixation (ORIF), hemi-hamate arthroplasty (HHA), volar plate arthroplasty (VPA), dynamic external fixation and extension block percutaneous pinning in proximal interphalangeal (PIP) joint injuries.
Methods:
This retrospective study was conducted on 34 patients who were surgically treated for PIP joint dislocation or fracture dislocation between 2016 and 2022. Patients were grouped according to treatment method. Visual analogue scores (VAS), Quick disabilities of the arm,shoulder and hand (DASH) scores, range of motion (ROM), grip strengths and subluxation on radiographs were analyzed.
Results:
Mean age was 35.7±15.9 years. 8 patients underwent extension block percutaneous pinning, 7 patients each underwent dynamic external fixation and ORIF, and 6 patients each underwent VPA and HHA. Median Quick DASH score was 4.5 [0-10.7], median VAS was 1 [0-2], median ROM was 75° [56.3°-90°] mean grip strength difference was 4.4±7.6 kg. There were no differences between groups in Quick DASH (p=0.309), VAS (p=0.219), ROM (p=0.719), loss of grip strength (p=0.938). Subluxation was seen in 7 patients. There was no statistically significant difference between clinical results of patients with and without subluxation (p=0.892 for Quick DASH, p=0.158 for VAS, p=0.164 for ROM).
Conclusion:
Choosing appropriate surgical treatment after PIP joint injury improves clinical and functional outcomes. It should be kept in mind that application of dynamic external fixation is challenging in terms of patient comfort and re-subluxation may occur in patients who underwent VPA.
Key words: dislocation; hemi-hamate arthroplasty; proximal interphalangeal joint
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