Background: Previous studies have explored the outcomes of closed reduction and percutaneous pinning in managing dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint, although these studies were limited in scope.
Objectives: This study aims to report this technique’s clinical and radiographic outcomes in the treatment of PIP joint dorsal fracture-dislocation.
Methods: We conducted a retrospective review of twelve patients with unstable dorsal fracture-dislocations of the PIP joint that underwent closed reduction and percutaneous pinning. Parameters, including range of motion (ROM), grip strength, pinch strength, and PIP joint pain assessed via a visual analog scale (VAS). The PIP joint function was evaluated using quick disabilities of the arm, shoulder, and hand (Quick-DASH) questionnaire.
Results: At a mean follow-up of 18.6 months, the mean PIP ROM was 99±5.3 (range 90-110), representing 90.2% of the contralateral side (P=0.31). The mean flexion contracture and extension lag were 6.7±3.2º and 6.3±3.1º, respectively. Patients reported a mean VAS score of 3.3±1.5 and a mean quick disabilities of the arm, shoulder, and hand (Quick-DASH) score of 10.8±6.1 points. The mean pinch strength of the involved hand averaged 80.4% of the contralateral side (P=0.19), and the mean grip strength averaged 92.29% (P=0.28). All patients achieved union with radiographically concentric joints, and no subluxation or dislocation events occurred during follow-up. Although radiographic evidence of arthritic changes was observed in all patients, these changes were clinically asymptomatic.
Conclusion: Closed reduction and percutaneous pinning offer a simple, accessible, and minimally invasive technique for managing PIP joint dorsal fracture-dislocations. The observed clinical and radiographic outcomes demonstrate stability and concentricity of the joint, suggesting this technique as a valuable surgical option for such injuries.
Type of Study:
Research Article |
Subject:
Hand surgery / Elbow Received: 2022/03/18 | Accepted: 2022/06/12 | Published: 2022/11/1