title: Management of difficult intra-articular fractures or fracture dislocations of the proximal interphalangeal joint.
abstract: Intra-articular fractures or fracture dislocations of the proximal interphalangeal joint are difficult clinically because the bone and soft tissue structures are small and intricate. Suboptimal treatment of intra-articular fractures typically leads to functional impairment of the hand. This article reviews the current methods of treatment, together with the senior author's experience in treating difficult proximal interphalangeal joint fractures and dislocations. Besides conservative treatments, surgical treatments include open or closed reduction with traditional Osteosynthesis, such as K-wires, screws or plates. Among recent developments are the percutaneous application of thin cannulated compression screws and novel dynamic external fixators. After a preferred minimally invasive treatment with stable reconstruction of the articular surface, sufficient aftercare is necessary to improve surgical outcomes.
authors.affiliation: Department of Plastic, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Luebeck, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Liodaki
authors.affiliation: Department of Hand Surgery, Affiliated Hospital of Nantong University, Jiangsu, China.
authors.forename: S G
authors.initials: SG
authors.lastname: Xing
authors.affiliation: Department of Plastic, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Luebeck, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Mailaender
authors.affiliation: Department of Plastic, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Luebeck, Germany felix.stang@gmx.de.
authors.forename: F
authors.initials: F
authors.lastname: Stang
mesh_terms: D001178:Arthroplasty; D005384:Finger Joint; D005593:Fracture Fixation, Internal; D006801:Humans; D057072:Intra-Articular Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D004204:Joint Dislocations / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography
keywords: Intra-articular fracture; arthroplasty; cannulated screw fixation; dynamic traction splinting; proximal interphalangeal joint