title: Hemi-hamate arthroplasty versus transarticular Kirschner wire fixation for unstable dorsal fracture-dislocation of the proximal interphalangeal joint in the hand.
abstract: Following the introduction of the hemi-hamate arthroplasty (HHA) technique to our unit, we sought to evaluate the early clinical outcomes achieved with this method of fixation and compare these with simple trans-articular Kirschner wire (K-wire) fixation for dorsal fracture dislocations (DFD) of the proximal interphalangeal joint (PIPJ). Ninteen patients underwent fixation of these injuries with either K-wire fixation (12/19) or hemi-hamate bone grafting (7/19) between 2005 and 2011. At a mean follow-up of 14 weeks median arc of movement at the PIPJ was 65° (range 31° to 108°) following HHA and 56° (range 9° to 85°) (p = 0.82) following temporary transarticular K-wire fixation. Median fixed flexion deformity (FFD) was 20° and 15° for hemi-hamate bone grafting and K-wire fixation respectively. Based upon our findings, transarticular K-wire fixation produced equivalent outcomes to HHA for unstable DFD of the PIPJ in the hand.
authors.affiliation: Hand Surgery Unit, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
authors.forename: R C
authors.initials: RC
authors.lastname: Barksfield
authors.forename: B
authors.initials: B
authors.lastname: Bowden
authors.forename: A J
authors.initials: AJ
authors.lastname: Chojnowski
mesh_terms: D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D001864:Bone Wires; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D051225:Hamate Bone / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012189:Retrospective Studies
keywords: Fracture and Dorsal Dislocation; Hemi-Hamate Arthroplasty; Kirschner wire Fixation; Proximal Interphalangeal Joint