Open Reduction of Proximal Interphalangeal Fracture-Dislocation through a Midlateral Incision Using Absorbable Suture Materials

Abstract

Background Fracture-dislocation of the proximal interphalangeal (PIP) joint is a relativelycommon injury. Varioustreatmentsforfracture–dislocation ofthe PIP joint have been reported.Inthepresentstudy,weperformedopenreductionthroughamidlateral incisionusingabsorbablesuturesto reduce the small bone fragments and performed volar plate repair.Methods We treated nine patients with fracture-dislocation of the PIP joint with smallfractured bone fragments too small for pinning or screw fixation. Patients with volar plateinjurywere treatedwith open reduction and volar plate repair atthe periosteumofthemiddlephalangeal bone base by the modified Kessler method using absorbable sutures. All patientswere placed in a dorsal aluminum extension block splint, which maintained the PIP joint inapproximately 30 degrees of flexion to avoid excessive tension on the sutured volar plate.Results At a mean final follow-up of postoperative 9 months, all patients were evaluatedradiographically and had adequate alignment ofthe PIP joint and reduction ofthe displacedbone fragments. Range ofmotionwasimproved and therewere no complications.Conclusions This technique is an excellent alternative to the current method of treatingpatientswith fracture-dislocationsthatinclude smallfragmentsthat are too smallfor pinningor screw fixation. It is a less invasive surgical method and enables stable reduction and earlyexercisewithout noticeable complications.

Keywords

• Fingerjoint
• Intra-articularfractures
• Volar plate
• Sutures