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Handchir Mikrochir Plast Chir 2014; 46(03): 192-195
DOI: 10.1055/s-0034-1366998
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© Georg Thieme Verlag KG Stuttgart · New York

Modified Proximal Interphalangeal Joint Palmar Plate Arthroplasty after Fracture Dislocation: A Case Report

Modifizierte Interpositionsarthroplastik der palmaren Platte des proximalen Interphalangealgelenkes bei Luxationsfraktur: Ein Fallbericht
B. Piotuch
1   Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland
,
P. Puchalski
1   Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland
,
A. Zyluk
1   Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland
› Author Affiliations
Further Information

Publication History

received 14 December 2013

accepted 08 January 2014

Publication Date:
18 June 2014 (online)

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Abstract

We present the results of treatment of a neglected fracture of the base of the middle phalanx of the ring finger, with dorsal proximal interphalangeal joint dislocation. A modified palmar plate arthroplasty technique was used with the removal of bony remnants and non-anatomic palmar plate insertion to the fracture site. At one-year follow-up the patient showed excellent recovery with an active range of motion of the ring finger of 290° (93% of the other side), strong total grip (48 kg) and a quick DASH score of 11. X-ray images showed perfect re-building of the palmar lip of the base of the middle phalanx with no signs of arthritis. Other options for the treatment of acute and chronic PIP joint fracture dislocations are discussed.

Zusammenfassung

Wir berichten über das Ergebnis der Behandlung einer nicht erkannten Fraktur der Mittelgliedbasis des Ringfingers mit dorsaler Luxation des Mittelgelenkes. Nach Entfernung des Knochenfragmentes wurde eine modifizierte Interpositionsarthroplastik mit extra-anatomischer Refixation der palmaren Platte an der Ausbruchstelle des Knochenfragmentes vorgenommen. Ein Jahr postoperativ fand sich ein sehr gutes Ergebnis mit einer aktiven Beweglichkeit des Ringfingers von 290° (93% der Gegenseite), einer Griffkraft von 48 kg und 11 Punkten beim quickDASH Score. Die Röntgenaufnahmen zeigten ein schönes Remodelling der palmaren Lippe der Mittelgliedbasis ohne Hinweise auf eine Arthrose. Behandlungsoptionen für frische und veraltete Luxationsfrakturen des Fingermittelgelenkes werden diskutiert.

Key words

PIP fracture dislocation - modified palmar plate arthroplasty

Schlüsselwörter

Mittelgelenksluxations­frakturen - modifizierte Interpositions­arthroplastik
 

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