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• W2176869818 abstract "HypothesisChronic fractures affecting the PIP joint present a big challenge for hand surgeons. There is no classification for this problem. The purpose of the study is to classify this chronic fracture. We hypothesize that each stage of chronic PIP joint fractures have different appropriate treatment.MethodsConsecutive patients with chronic PIP joint fractures presented to our center from May 2007 to Dec 2014 were included in the study. Patients who were indicated for reconstructive surgery were divided into 5 different groups according to severity of the joint injuries, and received relevant reconstructive procedures. Outcome measurements included radiographic evidence of bone healing, joint alignment and/or collapse, ROM of PIP joint, and the donor site morbidity.ResultsThere were 36 patients with chronic PIP joint fractures presented to our center during the period. Among them, 23 patients received reconstructive surgery. The average age was 32 (15-54) years, with 21 males. These patients were divided into 5 groups: 2 cases of nonunion, 6 cases of malunion, 9 cases of partial osteochondral defect, 3 cases of posttraumatic arthritis, and 4 cases of joint collapse. Surgeries were performed 1 months to 3 years after the fracture or previous surgery. Following procedures were performed: ORIF + BG for nonunion, corrective osteotomy for malunion, osteochondral graft for partial osteochondral defect, vascularised joint transfer for posttraumatic arthritis, and vascularised joint transfer following distraction for joint collapse. The average arc of motion for the involved PIP joint was 79° (35°–95°). The distal interphalangeal (DIP) joint average arc of motion was 50° (0°-65°). Bony union was obtained in 22 patients. There was one painful degenerative arthritis after osteochondral bone graft and one refracture after vascularized joint transfer who converted to a revision surgery. Twenty-one patients had no pain, and 20 patients were satisfied with their function.Summary PointsView Large Image Figure ViewerDownload Hi-res image Download (PPT) HypothesisChronic fractures affecting the PIP joint present a big challenge for hand surgeons. There is no classification for this problem. The purpose of the study is to classify this chronic fracture. We hypothesize that each stage of chronic PIP joint fractures have different appropriate treatment. Chronic fractures affecting the PIP joint present a big challenge for hand surgeons. There is no classification for this problem. The purpose of the study is to classify this chronic fracture. We hypothesize that each stage of chronic PIP joint fractures have different appropriate treatment. MethodsConsecutive patients with chronic PIP joint fractures presented to our center from May 2007 to Dec 2014 were included in the study. Patients who were indicated for reconstructive surgery were divided into 5 different groups according to severity of the joint injuries, and received relevant reconstructive procedures. Outcome measurements included radiographic evidence of bone healing, joint alignment and/or collapse, ROM of PIP joint, and the donor site morbidity. Consecutive patients with chronic PIP joint fractures presented to our center from May 2007 to Dec 2014 were included in the study. Patients who were indicated for reconstructive surgery were divided into 5 different groups according to severity of the joint injuries, and received relevant reconstructive procedures. Outcome measurements included radiographic evidence of bone healing, joint alignment and/or collapse, ROM of PIP joint, and the donor site morbidity. ResultsThere were 36 patients with chronic PIP joint fractures presented to our center during the period. Among them, 23 patients received reconstructive surgery. The average age was 32 (15-54) years, with 21 males. These patients were divided into 5 groups: 2 cases of nonunion, 6 cases of malunion, 9 cases of partial osteochondral defect, 3 cases of posttraumatic arthritis, and 4 cases of joint collapse. Surgeries were performed 1 months to 3 years after the fracture or previous surgery. Following procedures were performed: ORIF + BG for nonunion, corrective osteotomy for malunion, osteochondral graft for partial osteochondral defect, vascularised joint transfer for posttraumatic arthritis, and vascularised joint transfer following distraction for joint collapse. The average arc of motion for the involved PIP joint was 79° (35°–95°). The distal interphalangeal (DIP) joint average arc of motion was 50° (0°-65°). Bony union was obtained in 22 patients. There was one painful degenerative arthritis after osteochondral bone graft and one refracture after vascularized joint transfer who converted to a revision surgery. Twenty-one patients had no pain, and 20 patients were satisfied with their function. There were 36 patients with chronic PIP joint fractures presented to our center during the period. Among them, 23 patients received reconstructive surgery. The average age was 32 (15-54) years, with 21 males. These patients were divided into 5 groups: 2 cases of nonunion, 6 cases of malunion, 9 cases of partial osteochondral defect, 3 cases of posttraumatic arthritis, and 4 cases of joint collapse. Surgeries were performed 1 months to 3 years after the fracture or previous surgery. Following procedures were performed: ORIF + BG for nonunion, corrective osteotomy for malunion, osteochondral graft for partial osteochondral defect, vascularised joint transfer for posttraumatic arthritis, and vascularised joint transfer following distraction for joint collapse. The average arc of motion for the involved PIP joint was 79° (35°–95°). The distal interphalangeal (DIP) joint average arc of motion was 50° (0°-65°). Bony union was obtained in 22 patients. There was one painful degenerative arthritis after osteochondral bone graft and one refracture after vascularized joint transfer who converted to a revision surgery. Twenty-one patients had no pain, and 20 patients were satisfied with their function. Summary Points" @default.
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• W2176869818 date "2015-09-01" @default.
• W2176869818 modified "2023-09-26" @default.
• W2176869818 title "Individualized Reconstruction of Chronic Fractures Affecting the PIP Joint" @default.
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• W2176869818 doi "https://doi.org/10.1016/j.jhsa.2015.06.043" @default.
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