J Korean Soc Surg Hand.  2014 Sep;19(3):116-123. 10.12790/jkssh.2014.19.3.116.

Open Reduction and Internal Fixation for Intraarticular Volar Fractures of the Middle Phalanx in Proximal Interphalangeal Joint

• Lee HJ
• Lee JH
• Bong ST
• Kim WH
• Han SH

• KMID: 2194132
• DOI: http://doi.org/10.12790/jkssh.2014.19.3.116

Abstract

PURPOSE
We report clinical and radiographic outcomes after internal fixation of intraarticular volar fractures of the middle phalanx base.
METHODS
A retrospective review was conducted on 11 patients who had been treated with miniplate or screw for acute proximal interphalangeal joint fracture, after adjusting for the cases excluding severe comminuted or open fractures. The participants consisted of 9 males and 2 females, with average age of 43.7 years and with average follow-up period of 15.2 months. Bony union, change of articular side were examined through radiographs, and functional results were evaluated by means of the total active range of motion (TAM) and the disabilities of the arm, shoulder, and hand (DASH).
RESULTS
Of 11 cases of a finger fracture, 7 cases were fixed by miniplate with screws and 4 cases by screws alone. At the final follow-up retrospection, the average range of proximal interphalangeal joint motion was 95degrees, the average TAM was 243.2degrees, and the average DASH score was 7.4. Average 2.8 months was spent from the finger fracture to bony union. There was no case of degenerative change.
CONCLUSION
Open reduction and internal fixation with screws for acute intraarticular fractures of the middle phalanx base showed favorable results in our study and it could be one of recommendable treatment options.

Keyword

Proximal interphalangeal joint; Midphalanx base fracture; Open reduction and internal fixation

MeSH Terms

Arm
Female
Fingers
Follow-Up Studies
Fractures, Open
Hand
Humans
Intra-Articular Fractures
Joints*
Male
Range of Motion, Articular
Retrospective Studies
Shoulder

Figure

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  Fig. 1. Zigzag skin incisions on the volar side of the finger.

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  Fig. 2. The reduction of displaced fracture using a small instrument.

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  Fig. 3. (A, B) Internal fixation using miniplate and screws.

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  Fig. 4. Proximal phalanx base intraarticular fracture with dorsal subluxation.

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  Fig. 5. (A, B) Bony union and articulation with good alignment taken at the follow-up radiographs.

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  Fig. 6. (A, B) The postoperative recovery of near-full range of motion.

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  Fig. 7. Volar fragment and dorsal subluxation of proximal interphalangea joint with P2 base intraarticular fracture.

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  Fig. 8. Open reduction and internal fixation using 2 screws.

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  Fig. 9. (A, B) Bony union without degenerative change taken at the follow-up radiographs.

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  Fig. 10. (A, B) The postoperative recovery of full range of motion.

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