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CC BY-NC 4.0 · Arch Plast Surg 2021; 48(06): 635-640
DOI: 10.5999/aps.2021.00220
Hand/Peripheral Nerve
Original Article

Ligamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study

Jean-Charles Hery 
Department of Orthopedics and Traumatology, Caen University Hospital, Caen, France
,
Baptiste Picart 
Department of Orthopedics and Traumatology, Caen University Hospital, Caen, France
,
Mélanie Malherbe 
Department of Orthopedics and Traumatology, Caen University Hospital, Caen, France
,
Christophe Hulet 
Department of Orthopedics and Traumatology, Caen University Hospital, Caen, France
,
Aude Lombard 
Department of Orthopedics and Traumatology, Caen University Hospital, Caen, France
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Background Injuries to the proximal interphalangeal (PIP) joint are common and complex. However, the treatment of osteochondral defects of the head of the proximal phalanx has rarely been described. Herein, we propose a new technique for the management of unicondylar defects of the proximal phalanx that can restore joint amplitudes and provide PIP stability.

Methods In this cadaveric feasibility study, unicondylar defects were generated using striking wedges and chisels. First, a transverse tunnel measuring 2 mm in diameter passing through the head of the proximal phalanx was made. A second tunnel at the base of the middle phalanx with the same diameter was then created. The hemitendon of the flexor carpi radialis graft was passed through each of these tunnels. The proximal end of the graft was interposed in the area with a loss of bone substance. The ligamentoplasty was then tensed and fixed by two anchors on the proximal phalanx. Joint amplitudes and frontal stability were measured preoperatively and postoperatively.

Results There was no significant change in the joint’s range of motion: preoperatively, the mean mobility arcs were –2° to 113.80°, and they were –2° to 110° after the procedure (P=0.999). There was no significant difference in joint stability (P>0.05).

Conclusions Ligamentoplasty with PIP interposition appears to be a possible solution for the management of unicondylar defects of the proximal phalanx. An evaluation of clinical results is planned in order to definitively confirm the validity of this procedure.

Keywords

Anatomy - Articular fracture - Finger - Collateral ligament reconstruction

We would like to thank the team of the Faculty’s Anatomy Laboratory.




Publication History

Received: 24 January 2021

Accepted: 29 July 2021

Article published online:
22 May 2022

© 2021. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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