[Surgical treatment of closed articular fractures of the proximal interphalangeal joints (20 cases)].
20 cases of intra-articular fractures of proximal interphalangeal joints were reviewed with a mean follow-up of 3 years 9 months, and a minimum follow-up of 1 year, corresponding to 10 fractures of the head of P1 (7 condylar fractures, 2 supra-intercondylar fractures and 1 diaphyseal fracture with an articular crevice) and 10 fractures of the basis of P2 corresponding to distraction-impaction fractures in 8 cases. The fractures were treated by open reduction and osteosynthesis by screws, mini-screws, or pins, completed by an arthrodesis pin in 3 cases. All fractures were closed, isolated, and too unstable to be treated orthopaedically. Global results were: 14 excellent and good results, 4 moderate results and 2 poor results according to Steel's criteria. No serious early complications were observed. The difficulty of treatment and the duration of rehabilitation are greater in fractures of the base of P2 than for fractures of the head of P1. No statistically significant factor was identified due to the small size of this series, but, the factors of poor prognosis essentially consist of late mobilization and reoperations for failure of percutaneous pinning of a fracture of the basis of P2.
Service de Chirurgie Orthopédique et Reconstructrice de l'Hôpital Bichat, Paris.
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C
Touam
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Bleton
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JY
Alnot
D000328:Adult; D001858:Bone Nails; D001863:Bone Screws; D005260:Female; D005383:Finger Injuries / Q000145:classification / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D005596:Fractures, Closed / Q000145:classification / Q000601:surgery*; D006801:Humans; D008297:Male; D011379:Prognosis; D016896:Treatment Outcome
Traitement chirurgical des fractures articulaires fermées des articulations interphalangiennes proximales. A propos de vingt cas.