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J Hand Surg Eur Vol. 2015 Jan;40(1):16-23. doi: 10.1177/1753193414559464. Epub 2014 Nov 26.

Management of difficult intra-articular fractures or fracture dislocations of the proximal interphalangeal joint.

Author information

1
Department of Plastic, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Luebeck, Germany.
2
Department of Hand Surgery, Affiliated Hospital of Nantong University, Jiangsu, China.
3
Department of Plastic, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Luebeck, Germany felix.stang@gmx.de.

Abstract

Intra-articular fractures or fracture dislocations of the proximal interphalangeal joint are difficult clinically because the bone and soft tissue structures are small and intricate. Suboptimal treatment of intra-articular fractures typically leads to functional impairment of the hand. This article reviews the current methods of treatment, together with the senior author's experience in treating difficult proximal interphalangeal joint fractures and dislocations. Besides conservative treatments, surgical treatments include open or closed reduction with traditional Osteosynthesis, such as K-wires, screws or plates. Among recent developments are the percutaneous application of thin cannulated compression screws and novel dynamic external fixators. After a preferred minimally invasive treatment with stable reconstruction of the articular surface, sufficient aftercare is necessary to improve surgical outcomes.

KEYWORDS:

Intra-articular fracture; arthroplasty; cannulated screw fixation; dynamic traction splinting; proximal interphalangeal joint

PMID:
25427554
DOI:
10.1177/1753193414559464
[Indexed for MEDLINE]

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