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SAGE Open Med Case Rep 2021 3;9:2050313X211021180. Epub 2021 Jun 3.

Division of Plastic & Reconstructive Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.

Complex dislocation of the metacarpophalangeal joint of the index finger is rare and often requires surgical intervention. Here, we present a case of an index finger metacarpophalangeal joint dislocation requiring open reduction due to obstruction by a displaced volar plate and the intra-articular entrapment of a sesamoid bone. Surgical approach was performed dorsally, allowing easy visualization of the volar plate and sesamoid bone as well as minimizing risk to the radial digital nerve to the index finger. Read More

J Hand Surg Asian Pac Vol 2021 Jun;26(2):158-165

Department of Hand Surgery, Plastic and Reconstructive Surgery, Centre Chirurgical Emile Gallé, Nancy University Hospital, Nancy, France.

The purpose of this retrospective study was to report and compare the outcomes of the MAIA prosthesis and trapeziectomy for trapeziometacarpal osteoarthritis. We included 92 consecutive patients (8 men, 84 women) with a mean age of 57 years (range 44-75 years) who underwent trapeziectomy (44 patients) or trapeziometacarpal joint replacement with a MAIA prosthesis (48 patients) for painful osteoarthritis. All patients were evaluated (pain, range of motion, strength, function, X-rays) by an independent examiner. Read More

J Pediatr 2021 Apr 2. Epub 2021 Apr 2.

Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy; Institute for Maternal and Child Health, Italian Research Hospital "Burlo Garofolo", Trieste, Italy.

J Wrist Surg 2021 Apr 27;10(2):164-168. Epub 2020 Aug 27.

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

 Fracture-dislocations of all four ulnar (second to fifth) carpometacarpal (CMC) joints are rare hand injuries and frequently overlooked or missed. These injuries can be treated conservatively when closed reduction is successfully achieved, though they are sometimes irreducible and unstable.  We report the case of a 17-year-old boy involved in a vehicular accident. Read More

Case Rep Orthop 2021 15;2021:6684553. Epub 2021 Mar 15.

2nd Orthopaedic Department, General Hospital of Thessaloniki "Papageorgiou", Ring Road-N. Eukarpia, 56403 Thessaloniki, Greece.

Double interphalangeal joint dislocation of the same finger is a rare condition. We report two cases of adolescent athletes with distal and proximal interphalangeal joint dislocation. The diagnosis was confirmed with plain radiograph, while anatomical reduction was easily obtained with gentle longitudinal traction. Read More

Tech Hand Up Extrem Surg 2021 Mar 24. Epub 2021 Mar 24.

Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Proximal interphalangeal joint injuries are common and are a major risk for functional deficits of the finger that affect range of motion and grip strength. Impacted intra-articular fractures and fracture dislocations of the middle phalanx base are challenging to treat because of troublesome joint reduction and difficulties in achieving articular congruity. Although treatment algorithms have been published, the anatomically delicate proximal interphalangeal joint often remains incomplete in function and may result in post-traumatic pain, stiffness, and osteoarthritis. Read More

Hand (N Y) 2021 Jan 24:1558944720988077. Epub 2021 Jan 24.

McMaster University, Hamilton, ON, Canada.

This article describes the first case of successful nerve grafting for posterior interosseous nerve (PIN) palsy secondary to radiocapitellar joint entrapment 2 years following closed reduction (CR) of a pediatric Monteggia fracture-dislocation (MFD). Patient notes were examined. The literature was reviewed to determine whether similar cases or techniques had been reported. Read More

BMC Musculoskelet Disord 2021 Jan 4;22(1). Epub 2021 Jan 4.

Department of Hand Surgery, Beijing Ji Shui Tan Hospital and the 4th Medical College of Peking University, Xin jie kou dong jie 31, Xi Cheng Qu, Beijing, 100035, China.

Background: Restoration of joint congruity is an important factor for the prevention of subsequent arthritis in patients with Bennett's fracture. Surgical treatment of Bennett's fracture is thus generally recommended for displaced intra-articular fractures to the proximal aspect of the thumb metacarpal. Fluoroscopic examination is used to evaluate the adequacy of closed reduction after pinning of Bennett's fracture. Read More

J Hand Microsurg 2020 Oct 10;12(Suppl 1):S9-S15. Epub 2020 Aug 10.

Department of Orthopaedic Surgery, Jersey City Medical Center-RWJBarnabas Health, Jersey City, New Jersey, United States.

Proximal interphalangeal joint (PIPJ) fractures and fracture-dislocations are common hand injuries and recognition of this injury pattern is essential in the management of these fractures. Although a variety of treatment options have been reported in the literature, the optimal treatment remains controversial. MEDLINE, EMBASE, and The Cochrane Library Database were screened for treatment strategies of PIPJ fracture and fracture-dislocation. Read More

Arch Bone Jt Surg 2020 Nov;8(6):739-743

Department of Orthopedics, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Proximal interphalangeal (PIP) fracture-dislocation is a relatively common injury that results from "jamming" a finger. Treatment hinges on the degree of articular surface involvement, which determines stability of the joint. For unstable injuries, a variety of surgical interventions have been described including extension block pinning, open reduction internal fixation, volar plate arthroplasty, static or dynamic external fixation, and hemi-hamate reconstruction. Read More

J Hand Surg Asian Pac Vol 2020 Dec;25(4):427-433

Department of Orthopedic Surgery, Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand.

The pins and rubbers traction system is widely used to treat unstable proximal interphalangeal (PIP) joint fracture-dislocations. However, dealing with rubber bands can be difficult due to its elasticity and weakness. The purpose of this study was to report the results of an alternative dynamic external fixator technique for unstable PIP joint injuries. Read More

Neuromuscul Disord 2020 10 7;30(10):833-838. Epub 2020 Sep 7.

APHP, Department of Neurology, Raymond Poincaré Hospital, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, 104 Bld Raymond Poincaré, 92380 Garches, France; Service de Neurologie, U1179 UVSQ-INSERM Handicap Neuromusculaire : Physiologie, Biothérapie et Pharmacologie appliquées, UFR Simone Veil-Santé, Université Versailles Saint Quentin en Yvelines, Pôle neuro-locomoteur, Hôpital Raymond Poincaré, 104 boulevard Raymond Poincaré, 92380 Paris-Saclay, France. Electronic address:

Tenascin-X, is an extracellular matrix glycoprotein expressed in skin, muscle, tendons, and blood vessels with an anti-adhesive function. Biallelic Tenascin-X mutations cause classical-like Ehlers-Danlos syndrome. We report a 46-year-old woman with slowly progressive weakness of the lower limbs and myalgia from age 28 years. Read More

J Hand Surg Am 2020 Oct 28;45(10):991.e1-991.e7. Epub 2020 Aug 28.

Department of Orthopaedic Surgery, Gold Coast University Hospital, Southport, Queensland; School of Medicine, Griffith University, Gold Coast, Australia.

Chronic unreduced dislocations of the proximal interphalangeal joint are uncommon and management principles for these injuries have not been defined. The dislocation can be volar or dorsal and closed reduction is rarely successful owing to soft tissue contractures. We describe an extensile midaxial approach to the proximal interphalangeal joint for release of contractures, open reduction, and repair of critical structures. Read More

J Athl Train 2020 Jul;55(8)

University of Washington School of Medicine, Spokane Teaching Health Center.

Joint dislocations account for a small but important portion of all athletic injuries, with most occurring at the glenohumeral, patellofemoral, and interphalangeal joints. Athletic trainers are responsible for managing acute joint-dislocation injuries, which may include performing closed-reduction techniques when appropriate. To achieve optimal patient outcomes, the clinician should be formally trained and skilled in performing various techniques and familiar with the evidence supporting the selection of each technique. Read More

J Clin Orthop Trauma 2020 Jul-Aug;11(4):562-569. Epub 2020 Jun 9.

Dept. of Plastic, Hand, Burns and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamilnadu, India.

Objective: Fracture dislocations of the multiple carpometacarpal joints [CMCJ] of the fingers are uncommon injuries that can significantly compromise hand function and durability if managed sub-optimally. These injuries are at risk of being missed as they are commonly a part of major high energy trauma with associated more obvious and immediately threatening injuries getting all the attention. The clinical and radiological parameters which could help a surgeon to detect and analyse these injuries well are discussed. Read More

Eur J Orthop Surg Traumatol 2021 Jan 11;31(1):189-192. Epub 2020 Jul 11.

Department of Orthopedics, AIIMS, Raipur, India.

Second metacarpophalangeal dislocation is a rare entity, wherein correct diagnosis can be achieved by careful and experienced clinical examination that must be followed by radiological examination. This mostly requires open reduction either by dorsal or volar approach. Open reduction by volar approach is being used most widely but has more incidence of postoperative loss of sensation at volar aspect of finger due to neurovascular injury (digital nerve and vessel) and also required more extensive dissection. Read More

Arch Orthop Trauma Surg 2020 Aug 25;140(8):1133-1141. Epub 2020 May 25.

St Andrews Centre for Plastic Surgery, Broomfield Hospital, Chelmsford, CM1 7ET, UK.

Introduction: Fracture-dislocation and pilon injuries of the proximal interphalangeal joints (PIPJ) continue to pose significant management challenges. Stable fracture configurations can be treated with extension block splinting or pinning. Unstable fractures usually require open or closed reduction and fixation either directly/internally onto the fracture using Kirschner wires, cerclage wires, screws or miniplates or indirectly/externally by ligamentotaxis using external fixators which can be dynamic or static. Read More

Zhongguo Gu Shang 2020 Mar;33(3):241-6

The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha 410208, Hunan, China.

Objective: To explore effects of Decoction (, BYHWD) on early callus X-ray evaluation and level of serum alkaline phosphatase in elderly patients with Colles fracture after manual reduction and splint external fixation.

Methods: From October 2016 to October 2018, 60 elderly patients with Colles fractures were treated with manual reduction and splint external fixation and were divided into experimental group and control group. There were 30 patients in control group, including 15 males and 15 females; aged from 56 to 75 years old with an average of (67. Read More

Handchir Mikrochir Plast Chir 2020 Feb 5;52(1):18-24. Epub 2020 Mar 5.

Bundang CHA Medical Center Department of Orthopaedic Surgery.

Purpose:  The purpose of this study was to investigate and compare the clinical and radiological results of ORIF with inter-fragment screw or buttress plate fixation of acute PIP joint fracture dorsal dislocation.

Patients And Methods:  Between January 2007 to December 2016, nineteen patients - 14 men and 5 women with an average age of 40.9 (19 to 64) years - were included in this study; 9 patients underwent small sized interfragmentary screw fixation and 10 patients underwent small buttress plating. Read More

Cochrane Database Syst Rev 2020 02 7;2:CD006080. Epub 2020 Feb 7.

Cairo University, KasrAlAiny School of Medicine, Cairo, Egypt.

Background: Fracture of the distal radius is a common clinical problem. A key method of surgical fixation is percutaneous pinning, involving the insertion of wires through the skin to stabilise the fracture. This is an update of a Cochrane Review published in 2007. Read More

J Orthop Surg Res 2019 Dec 21;14(1):459. Epub 2019 Dec 21.

Department of Orthopedics, The Forth Medical Center of the General Hospital of People's Liberation Army of China, Haidian District, Beijing, China.

Background: The management of old bony mallet fingers is complicated. The aim of the study is to present a new method of open reduction and compression with double Kirschner wires (K-wires) in treating old bony mallet fingers.

Methods: This was a retrospective analysis of patients with old closed bony mallet fingers treated between June 2013 and December 2016. Read More

Tech Hand Up Extrem Surg 2019 Dec;23(4):176-181

Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL.

Digital external fixation is often used for the management of complex injuries involving the proximal interphalangeal joint, including pilon fractures of the middle phalanx base and unstable fracture-dislocations. Several dynamic "homemade" constructs have been described which utilize only K-wires and rubber bands and allow early range of motion within the construct. Although these constructs are inexpensive and their application is fairly straightforward, their designs pose a few potential problems when the construct is stressed during rehabilitation efforts. Read More

Eur J Emerg Med 2020 Jun;27(3):193-196

Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea.

Objective: To investigate the effect of parental involvement in the manual reduction of pulled elbow in children.

Methods: We conducted a prospective case-control study from January to December 2018. The patients were under 6 years old with suspected radial head subluxation and were randomly assigned to two groups (an intervention group with a physician's and a parent's finger placed on the patient's radial head and a control group with the physician's finger only placed on the patient's radial head) according to the method of reduction. Read More

Tech Hand Up Extrem Surg 2020 Jun;24(2):79-84

Hand Surgery Center, National Hospital Organization Murayama Medical Center, Musashimurayama City, Tokyo, Japan.

Treatments of unstable dorsal fracture dislocations of the proximal interphalangeal (PIP) joint are very challenging. The authors performed modified hemihamate arthroplasty for these injuries in 13 patients (13 fingers). Our surgical technique was unique in the point that we put volarly oblique osteotomy in the coronal plane at the recipient site to create an adequate reconstruction of the volar lip of the articular surface of the middle phalanx. Read More

Bone Joint J 2019 10;101-B(10):1263-1271

Department of Research, Business Division Medicine, BG Kliniken - Klinikverbund der gesetzlichen Unfallversicherung gGmbH, Berlin, Germany.

Aims: The aim of this study was to investigate whether clinical and radiological outcomes after intramedullary nailing of displaced fractures of the fifth metacarpal neck using a single thick Kirschner wire (K-wire) are noninferior to those of technically more demanding fixation with two thinner dual wires.

Patients And Methods: This was a multicentre, parallel group, randomized controlled noninferiority trial conducted at 12 tertiary trauma centres in Germany. A total of 290 patients with acute displaced fractures of the fifth metacarpal neck were randomized to either intramedullary single-wire (n = 146) or dual-wire fixation (n = 144). Read More

Hand (N Y) 2019 Sep 13:1558944719873152. Epub 2019 Sep 13.

University of Pittsburgh Medical Center, PA, USA.

Treatment of proximal interphalangeal joint (PIPJ) fracture-dislocations is difficult given the potential long-term complications of the involved finger and entire hand. Several surgical methods have been utilized for management of these injuries, none of which have shown consistently favorable results. The purpose of this systematic review of the literature is to report the post-operative outcomes of multiple treatment modalities for PIPJ fracture-dislocations in various studies. Read More

Trauma Case Rep 2019 Oct 28;23:100243. Epub 2019 Aug 28.

Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan.

We describe the case of an 84-year-old woman with a dorsal dislocation of the metacarpophalangeal (MCP) joint of the left index finger. Closed reduction was performed at an orthopaedic clinic which led to an iatrogenic complete displacement of the second metacarpal head to the volar side. Because reduction was impossible, surgery was performed. Read More

Trauma Case Rep 2019 Oct 25;23:100225. Epub 2019 Jul 25.

Department of Orthopedic Surgery and Traumatology, Military Hospital Mohammed V (HMIMV), University Mohamed V Faculty of Medecine and Pharmacy, BP 10100 Rabat, Morocco.

Dislocation of the metacarpophalangeal joint is a rare injury. The index finger is most frequently involved, followed by the thumb; the little finger is very seldom affected. The Complex dislocation of the little finger metacarpophalangeal joint is extremely rare. Read More

Trauma Case Rep 2019 Oct 18;23:100222. Epub 2019 Jul 18.

Department of Orthopaedic Surgery & Traumatology II, Military Hospital Mohammed V, Rabat 10100, Morocco.

A pure divergent dislocation involving the index and middle finger carpometacarpal joints is an extremely rare injury. We present a case of 21-year-old military man, victim of a motor vehicle accident, admitted at the emergency department unable to move his left hand with major swelling. X-rays and CT scan showed a dorsal dislocation of second and palmar dislocation of the third carpometacarpal joints without associated fracture, In the Operating room under general anesthesia, patient underwent closed reduction and internal fixation with percutaneous K-Wires followed by cast immobilization during 6 weeks. Read More

Oper Orthop Traumatol 2019 Oct 25;31(5):384-392. Epub 2019 Jul 25.

AUVA Unfallkrankenhaus Lorenz Böhler - European Hand Trauma Center, 1200, Wien, Österreich.

Objective: Reconstruction of intra-articular impression fractures of the middle phalanx by percutaneous reduction over a small dorsal cortical window. Stabilization by lattice-like arranged K‑wires.

Indications: Impression fractures of the base of the middle phalanx with or without dislocation in the proximal interphalangeal joint. Read More