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DOI: 10.5999/aps.2014.41.4.394
Proximal Interphalangeal Joint Dislocations and Treatment: An Evolutionary Process
Background Proximal interphalangeal joint (PIPJ) dislocations represent a significant proportion of hand clinic visits and typically require frequent follow-ups for clinical assessment, orthotic adjustments, and physiotherapy. There are a large number of treatment options available for PIPJ dislocations, yet no prospective or controlled studies have been carried out, largely due to the diversity of the various types of injuries.
Methods We retrospectively reviewed all the PIPJ dislocations in our institution over a five-year period and directly compared the different splinting techniques that we have used over this time frame.
Results There were a total of 77 dislocations of the PIPJ (57 men and 20 women) that were included in our study. We found that our management has shifted gradually from complete immobilisation to controlled early mobilisation with figure-of-eight splints. Following treatment, the range of motion of the PIPJ in the figure-of-eight group was significantly greater than that in the other three methods (P<0.05) used. There were significantly fewer hospital visits in the figure-of-eight splint group than in the other treatment groups.
Conclusions The treatment of PIPJ dislocations has undergone a significant evolution in our experience. Early controlled mobilisation has become increasingly important, and therefore, splints have had to be adapted to allow for this. The figure-of-eight splint has yielded excellent results in our experience. It should be considered for all PIPJ dislocations, but careful patient selection is required to achieve optimum results.
Publication History
Received: 31 January 2014
Accepted: 21 April 2014
Article published online:
05 May 2022
© 2014. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
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References
- 1 Chinchalkar SJ, Gan BS. Management of proximal interphalangeal joint fractures and dislocations. J Hand Ther 2003; 16: 117-128
- 2 Deshmukh NV, Sonanis SV, Stothard J. Irreducible volar dislocations of the proximal interphalangeal joint. Emerg Med J 2005; 22: 221-223
- 3 Kannan RY, Wilmshurst AD. Unstable proximal interphalangeal joint dislocations: another cause. Emerg Med J 2006; 23: 819
- 4 Glickel SZ, Barron OA. Proximal interphalangeal joint fracture dislocations. Hand Clin 2000; 16: 333-344
- 5 Minamikawa Y, Horii E, Amadio PC. et al. Stability and constraint of the proximal interphalangeal joint. J Hand Surg Am 1993; 18: 198-204
- 6 Feehan LM, Tang CS, Oxland TR. Early controlled passive motion improves early fracture alignment and structural properties in a closed extra-articular metacarpal fracture in a rabbit model. J Hand Surg Am 2007; 32: 200-208
- 7 Freiberg A. Management of proximal interphalangeal joint injuries. Can J Plast Surg 2007; 15: 199-203
- 8 Bailie DS, Benson LS, Marymont JV. Proximal interphalangeal joint injuries of the hand. Part I: anatomy and diagnosis. Am J Orthop (Belle Mead NJ) 1996; 25: 474-477
- 9 Laporte JM, Berrettoni BA, Seitz Jr WH. et al. The figure-of-eight splint for proximal interphalangeal joint volar plate injuries. Orthop Rev 1992; 21: 457-462
- 10 Latta LL, Sarmiento A, Tarr RR. The rationale of functional bracing of fractures. Clin Orthop Relat Res 1980; (146) 28-36
- 11 Cyr LM, Ross RG. How controlled stress affects healing tissues. J Hand Ther 1998; 11: 125-130