Download PDF
J Hand Microsurg 2020; 12(S 01): S9-S15
DOI: 10.1055/s-0040-1713323
Review Article

Treatment for Acute Proximal Interphalangeal Joint Fractures and Fracture-Dislocations: A Systematic Review of the Literature

Arianna Gianakos
1   Department of Orthopaedic Surgery, Jersey City Medical Center–RWJBarnabas Health, Jersey City, New Jersey, United States
,
John Yingling
1   Department of Orthopaedic Surgery, Jersey City Medical Center–RWJBarnabas Health, Jersey City, New Jersey, United States
,
Christian M. Athens
1   Department of Orthopaedic Surgery, Jersey City Medical Center–RWJBarnabas Health, Jersey City, New Jersey, United States
,
Andrew E. Barra
1   Department of Orthopaedic Surgery, Jersey City Medical Center–RWJBarnabas Health, Jersey City, New Jersey, United States
,
John T. Capo
1   Department of Orthopaedic Surgery, Jersey City Medical Center–RWJBarnabas Health, Jersey City, New Jersey, United States
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Proximal interphalangeal joint (PIPJ) fractures and fracture-dislocations are common hand injuries and recognition of this injury pattern is essential in the management of these fractures. Although a variety of treatment options have been reported in the literature, the optimal treatment remains controversial. MEDLINE, EMBASE, and The Cochrane Library Database were screened for treatment strategies of PIPJ fracture and fracture-dislocation. Demographic data and outcome data were collected and recorded. A total of 37 studies including 471 patients and 480 fingers were reviewed. PIPJ range of motion (ROM) was greatest postoperatively in patients who underwent volar plate arthroplasty at 90.6 degrees. Dynamic external fixation resulted in the lowest PIP joint ROM with an average of 79.7 degrees. Recurrent pain and osteoarthritis were most often reported in extension block pinning at 38.5 and 46.2%, respectively. Open reduction and internal fixation had the highest rate of revision at 19.7%. Overall, the outcomes of PIP fractures and fracture-dislocations are based on the severity of injury, and the necessary treatment required. Closed reduction with percutaneous pinning and volar plate arthroplasty had good clinical and functional outcomes, with the lowest complication rates. Hemi-hamate arthroplasty and dynamic external fixation were utilized in more complex injuries and resulted in the lowest PIPJ ROM. This is a therapeutic, Level III study.

Keywords

proximal interphalangeal joint - fracture-dislocation - finger - hand - fracture - fixation - treatment

Supplementary Material



Publication History

Article published online:
10 August 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Caggiano NM, Harper CM, Rozental TD. Management of proximal interphalangeal joint fracture dislocations. Hand Clin 2018; 34 (02) 149-165
    CrossrefPubMedGoogle Scholar
  • 2 Ootes D, Lambers KT, Ring DC. The epidemiology of upper extremity injuries presenting to the emergency department in the United States. Hand (N Y) 2012; 7 (01) 18-22
    CrossrefPubMedGoogle Scholar
  • 3 Donovan DS, Podolnick JD, Reizner W. Barron OA, Catalano LW III, Glickel SZ. Accuracy and reliability of radiographic estimation of volar lip fragment size in PIP dorsal fracture-dislocations. Hand (N Y) 2019; 14 (06) 797-802
    CrossrefPubMedGoogle Scholar
  • 4 Williams CS IV. Proximal interphalangeal joint fracture dislocations: stable and unstable. Hand Clin 2012; 28 (03) 409-416
    CrossrefPubMedGoogle Scholar
  • 5 Bindra R, Colantoni Woodside J. Treatment of proximal interphalangeal joint fracture-dislocations. JBJS Rev 2015; 3 (12) e1
    CrossrefPubMedGoogle Scholar
  • 6 Haase SC, Chung KC. Current concepts in treatment of fracture-dislocations of the proximal interphalangeal joint. Plast Reconstr Surg 2014; 134 (06) 1246-1257
    CrossrefPubMedGoogle Scholar
  • 7 Viegas SF. Extension block pinning for proximal interphalangeal joint fracture dislocations: preliminary report of a new technique. J Hand Surg Am 1992; 17 (05) 896-901
    CrossrefPubMedGoogle Scholar
  • 8 Barton NJ. Fractures of the hand. J Bone Joint Surg Br 1984; 66 (02) 159-167
    CrossrefPubMedGoogle Scholar
  • 9 Agee JM. Unstable fracture dislocations of the proximal interphalangeal joint of the fingers: a preliminary report of a new treatment technique. J Hand Surg Am 1978; 3 (04) 386-389
    CrossrefPubMedGoogle Scholar
  • 10 Suzuki Y, Matsunaga T, Sato S, Yokoi T. The pins and rubbers traction system for treatment of comminuted intraarticular fractures and fracture-dislocations in the hand. J Hand Surg [Br] 1994; 19 (01) 98-107
    CrossrefPubMedGoogle Scholar
  • 11 Schenck RR. Dynamic traction and early passive movement for fractures of the proximal interphalangeal joint. J Hand Surg Am 1986; 11 (06) 850-858
    CrossrefPubMedGoogle Scholar
  • 12 Wilson JN, Rowland SA. Fracture-dislocation of the proximal interphalangeal joint of the finger. J Bone Joint Surg Am 1966; 48 (03) 493-502
    CrossrefPubMedGoogle Scholar
  • 13 Green A, Smith J, Redding M, Akelman E. Acute open reduction and rigid internal fixation of proximal interphalangeal joint fracture dislocation. J Hand Surg Am 1992; 17 (03) 512-517
    CrossrefPubMedGoogle Scholar
  • 14 Freeland AE, Benoist LA. Open reduction and internal fixation method for fractures at the proximal interphalangeal joint. Hand Clin 1994; 10 (02) 239-250
    CrossrefPubMedGoogle Scholar
  • 15 Eaton RG, Malerich MM. Volar plate arthroplasty of the proximal interphalangeal joint: a review of ten years’ experience. J Hand Surg Am 1980; 5 (03) 260-268
    CrossrefPubMedGoogle Scholar
  • 16 Williams RM, Kiefhaber TR, Sommerkamp TG, Stern PJ. Treatment of unstable dorsal proximal interphalangeal fracture/dislocations using a hemi-hamate autograft. J Hand Surg Am 2003; 28 (05) 856-865
    CrossrefPubMedGoogle Scholar
  • 17 Ishida O, Ikuta Y, Kuroki H. Ipsilateral osteochondral grafting for finger joint repair. J Hand Surg Am 1994; 19 (03) 372-377
    CrossrefPubMedGoogle Scholar
  • 18 HastingsH, CapoJT, SteinbergB, et al. Hemicondylar hamate replacement arthroplasty for proximal interphalangeal joint fracture/dislocations. 54th Annual Meeting of the American Society for Surgery of the Hand 1999; Boston, MA:(Abstract). Available at: https://www.ncbi.nlm.nih.gov/pubmed/18590857. Accessed May 12, 2020
  • 19 Tekkis PP, Kessaris N, Enchill-Yawson M, Mani GV, Gavalas M. Palmar dislocation of the proximal interphalangeal joint–an injury not to be missed. J Accid Emerg Med 1999; 16 (06) 431-432
    CrossrefPubMedGoogle Scholar
  • 20 Bain GI, Mehta JA, Heptinstall RJ, Bria M. Dynamic external fixation for injuries of the proximal interphalangeal joint. J Bone Joint Surg Br 1998; 80 (06) 1014-1019
    CrossrefPubMedGoogle Scholar
  • 21 Grant I, Berger AC, Tham SK. Internal fixation of unstable fracture dislocations of the proximal interphalangeal joint. J Hand Surg [Br] 2005; 30 (05) 492-498
    CrossrefPubMedGoogle Scholar
  • 22 Calfee RP, Kiefhaber TR, Sommerkamp TG, Stern PJ. provides functional reconstruction of acute and chronic proximal interphalangeal fracture-dislocations. J Hand Surg Am 2009; 34 (07) 1232-1241
    CrossrefPubMedGoogle Scholar
  • 23 Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med 2009; 3 (03) e123-e130
    Google Scholar
  • 24 Lindenblatt N, Biraima A, Tami I, Giovanoli P, Calcagni M. Hemi-hamate autograft arthroplasty for acute and chronic PIP joint fracture dislocations. Handchir Mikrochir Plast Chir 2013; 45 (01) 13-19
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Burnier M, Awada T, Marin F Braun, Rostoucher P, Ninou M, Erhard L. Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts. J Hand Surg Eur Vol 2017; 42 (02) 188-193
    CrossrefPubMedGoogle Scholar
  • 26 Yang DS, Lee SK, Kim KJ, Choy WS. Modified hemihamate arthroplasty technique for treatment of acute proximal interphalangeal joint fracture-dislocations. Ann Plast Surg 2014; 72 (04) 411-416
    CrossrefPubMedGoogle Scholar
  • 27 Korambayil PM, Francis A. Hemi-hamate arthroplasty for pilon fractures of finger. Indian J Plast Surg 2011; 44 (03) 458-466
    CrossrefPubMedGoogle Scholar
  • 28 de KB Haseth, Neuhaus V, Mudgal CS. Dorsal fracture-dislocations of the proximal interphalangeal joint: evaluation of closed reduction and percutaneous Kirschner wire pinning. Hand (N Y) 2015; 10 (01) 88-93
    CrossrefPubMedGoogle Scholar
  • 29 Newington DP, Davis TR, Barton NJ. The treatment of dorsal fracture-dislocation of the proximal interphalangeal joint by closed reduction and Kirschner wire fixation: a 16-year follow up. J Hand Surg [Br] 2001; 26 (06) 537-540
    CrossrefPubMedGoogle Scholar
  • 30 Ikeda M, Ishii T, Kobayashi Y, Mochida J, Saito I, Oka Y. Percutaneous pinning of the displaced volar plate avulsion fracture of the PIP joint. Hand Surg 2009; 14 (2-3) 113-119
    CrossrefPubMedGoogle Scholar
  • 31 Vitale MA, White NJ, Strauch RJ. A percutaneous technique to treat unstable dorsal fracture-dislocations of the proximal interphalangeal joint. J Hand Surg Am 2011; 36 (09) 1453-1459
    CrossrefPubMedGoogle Scholar
  • 32 Keramidas E, Solomos M, Page RE, Miller G. The Suzuki frame for complex intra-articular fractures of the proximal interphalangeal joint of the fingers. Ann Plast Surg 2007; 58 (05) 484-488
    CrossrefPubMedGoogle Scholar
  • 33 Duteille F, Pasquier P, Lim A, Dautel G. Treatment of complex interphalangeal joint fractures with dynamic external traction: a series of 20 cases. Plast Reconstr Surg 2003; 111 (05) 1623-1629
    CrossrefPubMedGoogle Scholar
  • 34 Shen XF, Mi JY, Rui YJ. et al. Delayed treatment of unstable proximal interphalangeal joint fracture-dislocations with a dynamic external fixator. Injury 2015; 46 (10) 1938-1944
    CrossrefPubMedGoogle Scholar
  • 35 Ruland RT, Hogan CJ, Cannon DL, Slade JF. Use of dynamic distraction external fixation for unstable fracture-dislocations of the proximal interphalangeal joint. J Hand Surg Am 2008; 33 (01) 19-25
    CrossrefPubMedGoogle Scholar
  • 36 Agarwal AK, Karri V, Pickford MA. Avoiding pitfalls of the pins and rubbers traction technique for fractures of the proximal interphalangeal joint. Ann Plast Surg 2007; 58 (05) 489-495
    CrossrefPubMedGoogle Scholar
  • 37 De L Smet, Boone P. Treatment of fracture-dislocation of the proximal interphalangeal joint using the Suzuki external fixator. J Orthop Trauma 2002; 16 (09) 668-671
    CrossrefPubMedGoogle Scholar
  • 38 Deshmukh SC, Kumar D, Mathur K, Thomas B. Complex fracture-dislocation of the proximal interphalangeal joint of the hand. Results of a modified pins and rubbers traction system. J Bone Joint Surg Br 2004; 86 (03) 406-412
    CrossrefPubMedGoogle Scholar
  • 39 Ellis SJ, Cheng R, Prokopis P. et al. Treatment of proximal interphalangeal dorsal fracture-dislocation injuries with dynamic external fixation: a pins and rubber band system. J Hand Surg Am 2007; 32 (08) 1242-1250
    CrossrefPubMedGoogle Scholar
  • 40 Hynes MC, Giddins GE. Dynamic external fixation for pilon fractures of the interphalangeal joints. J Hand Surg [Br] 2001; 26 (02) 122-124
    CrossrefPubMedGoogle Scholar
  • 41 Abou Elatta MM, Assal F, Basheer HM, El Morshidy AF, Elglaind SM, Abdalla MA. The use of dynamic external fixation in the treatment of dorsal fracture subluxations and pilon fractures of finger proximal interphalangeal joints. J Hand Surg Eur Vol 2017; 42 (02) 182-187
    CrossrefPubMedGoogle Scholar
  • 42 Theivendran K, Pollock J, Rajaratnam V. Proximal interphalangeal joint fractures of the hand: treatment with an external dynamic traction device. Ann Plast Surg 2007; 58 (06) 625-629
    CrossrefPubMedGoogle Scholar
  • 43 Badia A, Riano F, Ravikoff J, Khouri R, Gonzalez-Hernandez E, Orbay JL. Dynamic intradigital external fixation for proximal interphalangeal joint fracture dislocations. J Hand Surg Am 2005; 30 (01) 154-160
    CrossrefPubMedGoogle Scholar
  • 44 Syed AA, Agarwal M, Boome R. Dynamic external fixator for pilon fractures of the proximal interphalangeal joints: a simple fixator for a complex fracture. J Hand Surg [Br] 2003; 28 (02) 137-141
    CrossrefPubMedGoogle Scholar
  • 45 MacFarlane RJ, Gillespie S, Cashin F, Mahmood A, Cheung G, Brown DJ. Treatment of fracture subluxations of the proximal interphalangeal joint using a ligamentotaxis device: a multidisciplinary approach. J Hand Surg Eur Vol 2015; 40 (08) 825-831
    CrossrefPubMedGoogle Scholar
  • 46 Damert HG, Altmann S, Kraus A, Infanger M, Sattler D. Treatment of intraarticular middle phalanx fractures using the Ligamentotaxor®. Hand (N Y) 2013; 8 (04) 460-463
    CrossrefPubMedGoogle Scholar
  • 47 Körting O, Facca S, Diaconu M, Liverneaux P. Treatment of complex proximal interphalangeal joint fractures using a new dynamic external fixator: 15 cases. Chir Main 2009; 28 (03) 153-157
    CrossrefPubMedGoogle Scholar
  • 48 Hamilton SC, Stern PJ, Fassler PR, Kiefhaber TR. Mini-screw fixation for the treatment of proximal interphalangeal joint dorsal fracture-dislocations. J Hand Surg Am 2006; 31 (08) 1349-1354
    CrossrefPubMedGoogle Scholar
  • 49 Lee JY, Teoh LC. Dorsal fracture dislocations of the proximal interphalangeal joint treated by open reduction and interfragmentary screw fixation: indications, approaches and results. J Hand Surg [Br] 2006; 31 (02) 138-146
    CrossrefPubMedGoogle Scholar
  • 50 Khan W, Agarwal M, Muir L. Management of intra-articular fractures of the proximal interphalangeal joint by internal fixation and bone grafting. Arch Orthop Trauma Surg 2004; 124 (10) 688-691
    CrossrefPubMedGoogle Scholar
  • 51 Cheah AE, Tan DMK, Chong AKS, Chew WYC. Volar plating for unstable proximal interphalangeal joint dorsal fracture-dislocations. J Hand Surg Am 2012; 37 (01) 28-33
    CrossrefPubMedGoogle Scholar
  • 52 Singh T, Jayawardhana R, Craigen M, Rajaratnam V. Volar buttress plating for unstable dorsal fracture-dislocations of the proximal interphalangeal joint. J Hand Microsurg 2019; 11 (02) 106-110
    Article in Thieme ConnectPubMedGoogle Scholar
  • 53 Waris E, Mattila S, Sillat T, Karjalainen T. Extension block pinning for unstable proximal interphalangeal joint dorsal fracture dislocations. J Hand Surg Am 2016; 41 (02) 196-202
    CrossrefPubMedGoogle Scholar
  • 54 Maalla R, Youssef M, Ben G Jdidia, Khimiri C, Essadam H. Extension-block pinning for fracture-dislocation of the proximal interphalangeal joint. Orthop Traumatol Surg Res 2012; 98 (05) 559-563
    CrossrefPubMedGoogle Scholar
  • 55 Waris E, Alanen V. Percutaneous, intramedullary fracture reduction and extension block pinning for dorsal proximal interphalangeal fracture-dislocations. J Hand Surg Am 2010; 35 (12) 2046-2052
    CrossrefPubMedGoogle Scholar
  • 56 Dionysian E, Eaton RG. The long-term outcome of volar plate arthroplasty of the proximal interphalangeal joint. J Hand Surg Am 2000; 25 (03) 429-437
    CrossrefPubMedGoogle Scholar
  • 57 Lee LS, Lee HM, Hou YT, Hung ST, Chen JK, Shih JT. Surgical outcome of volar plate arthroplasty of the proximal interphalangeal joint using the Mitek micro GII suture anchor. J Trauma 2008; 65 (01) 116-122
    CrossrefPubMedGoogle Scholar
  • 58 Lee JJ, Park HJ, Choi HG, Shin DH, Uhm KI. Open reduction of proximal interphalangeal fracture-dislocation through a midlateral incision using absorbable suture materials. Arch Plast Surg 2013; 40 (04) 397-402
    Article in Thieme ConnectPubMedGoogle Scholar
  • 59 Kiefhaber TR, Stern PJ. Fracture dislocations of the proximal interphalangeal joint. J Hand Surg Am 1998; 23 (03) 368-380
    CrossrefPubMedGoogle Scholar
  • 60 McElfresh EC, Dobyns JH, O’Brien ET. Management of fracture-dislocation of the proximal interphalangeal joints by extension-block splinting. J Bone Joint Surg Am 1972; 54 (08) 1705-1711
    CrossrefPubMedGoogle Scholar
  • 61 Deitch MA, Kiefhaber TR, Comisar BR, Stern PJ. Dorsal fracture dislocations of the proximal interphalangeal joint: surgical complications and long-term results. J Hand Surg Am 1999; 24 (05) 914-923
    CrossrefPubMedGoogle Scholar
  • 62 Afendras G, Abramo A, Mrkonjic A, Geijer M, Kopylov P, Tägil M. Hemi-hamate osteochondral transplantation in proximal interphalangeal dorsal fracture dislocations: a minimum 4 year follow-up in eight patients. J Hand Surg Eur Vol 2010; 35 (08) 627-631
    CrossrefPubMedGoogle Scholar
  • 63 Capo JT, Hastings II H, Choung E, Kinchelow T, Rossy W, Steinberg B. Hemicondylar hamate replacement arthroplasty for proximal interphalangeal joint fracture dislocations: an assessment of graft suitability. J Hand Surg Am 2008; 33 (05) 733-739
    CrossrefPubMedGoogle Scholar