Abstract
Proximal interphalangeal (PIP) joint injuries with associated osteochondral defects are a challenging problem. Without restoration of a concentrically reduced PIP joint, posttraumatic articular degenerative changes will develop. The indications for hemihamate replacement arthroplasty (HHRA) are limited to volar defects of the middle phalanx base with an intact dorsal cortex and at least 10–20 % of the dorsal articular surface remaining on the base of the middle phalanx. Other osteoarticular PIP joint injuries include middle phalanx base sagittal defects, proximal phalanx unicondylar defects, combined proximal and middle phalangeal osteochondral defects from open injury, and isolated focal osteochondral defects. The goal of this chapter is to provide an overview of autograft options (other than HHRA) for PIP joint osteochondral defects, with a clinical vignette demonstrating reconstruction of a unicondylar injury of the proximal phalanx.
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