Reconstructive and salvage techniques for proximal interphalangeal joint fracture dislocations.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Sports Medicine

Background:

• Proximal interphalangeal joint (PIPJ) fracture dislocations are common sports injuries.
• Delayed presentation can lead to chronic stiffness, pain, and arthrosis.
• Unstable injuries often require surgical intervention for stable reduction and early mobilization.

Purpose of the Study:

• To review surgical options for proximal interphalangeal joint (PIPJ) fracture dislocations.
• To present an algorithm for managing PIPJ fracture dislocations requiring reconstructive or salvage procedures.
• To guide hand surgeons in treating complex PIPJ injuries.

Main Methods:

• Review of current literature on surgical techniques for PIPJ fracture dislocations.
• Categorization of procedures into reconstructive (restoring articular surface) and salvage (not restoring articular surface).
• Presentation of various reconstructive (e.g., hemi hamate arthroplasty, toe graft) and salvage (e.g., implant arthroplasty, arthrodesis) techniques.

Main Results:

• Multiple reconstructive techniques exist, including hemi hamate arthroplasty and toe osteochondral grafts.
• Salvage procedures include volar plate arthroplasty, implant arthroplasty, and arthrodesis.
• A management algorithm is proposed to aid surgical decision-making.

Conclusions:

• Effective management of PIPJ fracture dislocations depends on timely intervention and appropriate surgical technique.
• Reconstructive and salvage procedures offer solutions for complex or delayed cases.
• The proposed algorithm aims to optimize outcomes for PIPJ fracture dislocations.