Hemi-hamate osteochondral transplantation in proximal interphalangeal dorsal fracture dislocations: a minimum 4 year follow-up in eight patients.
Fracture dislocations of the PIP joint are challenging to treat. In hemi-hamate arthroplasty, the palmar lip joint surface is reconstructed using an osteochondral graft from the hamate and the immediate stability permits early movement. In the long term, collapse of non-vascularized osteochondral grafts might lead to degenerative arthritis. We examined the radiographic result after a minimum of 4 years with special reference to the development of osteoarthritis and its relation to clinical symptoms in eight patients, mean age 49 (25-66) years. After a mean of 60 (48-69) months, the arc of motion was 67° (45°-95°) at the PIP joint and grip strength was 91% of the uninjured side. The visual analogue score for pain (0-100) was 10 (0-70) mm. Severe arthritis (grade IV) was found in two and mild arthritis (grade II) in another two patients, but only one of these four cases had troublesome pain. The hemi-hamate technique is an attractive alternative to other treatment options, but some cases develop osteoarthritis in the medium term.
Afendras
G
G
Hand and Upper Extremity Unit, Department of Orthopaedics, Clinical Sciences, Lund University, Lund, Sweden. makisaf@gmail.com
Abramo
A
A
Mrkonjic
A
A
Geijer
M
M
Kopylov
P
P
Tägil
M
M
D000368:Aged; D016723:Bone Remodeling / Q000502:physiology; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D051225:Hamate Bone / Q000637:transplantation*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000209:etiology; D010147:Pain Measurement; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies