Comminuted Transarticular Fracture of the Middle Phalanx: A Non-standard Surgical Procedure

Fractures of the proximal interphalangeal (PIP) joint with fragment displacement should be promptly repaired after injury, though this does not ensure the return of pre-injury finger function. The most common surgical treatment involves open reduction and internal fixation (ORIF) or closed reduction and internal fixation (CRIF) using locking compression plate (LCP), intramedullary nails, or screws. In articular fractures of the hand and wrist, the surgical reduction of small fragments is generally less feasible to occur compared to long bone fractures. This article describes the case of a 58-year-old woman who presented to the emergency department with an injury to her right third finger. The injury resulted from a fall from a height. X-ray revealed a comminuted pilon fracture of the PIP joint. Due to the fracture type and age, the decision was made to utilize an arthroplasty technique using a semi-constrained 3S ORTHO prosthesis. The article describes the early results of treatment. A six-month follow-up examination revealed that the active flexion range of the PIP joint reached 75°, with no pain at rest or during function. The improvement in the patient's clinical condition allowed her to return to work.