Functional evaluation of volar plate advancement arthroplasty in fracture dislocation of proximal interphalangeal joint

Abstract

Introduction: Injuries of the proximal interphalangeal joint ranging from simple sprain to fracture dislocation, are most common injuries of the hand labelled as jammed finger. The management of these injuries are difficult and challenging to hand surgeon with potential long term sequelae of residual pain and stiffness. So our aim is to evaluate the result of volar plate advancement arthroplasty in these injuries. Materials and Methods: This is a retrospective study conducts between 2013 to 2017. In our study 10 cases (8 male and 2 female with average age 26.9y) of fracture dislocation of PIP joint with average 5.3 weeks after injury, operated by advancement of volar plate arthroplasty (in 3 case as a primary and in 7 cases as a secondary reconstructive procedure) with inclusive criteria of unstable joint and > 40% involvement of volar surface of middle phalanx. Results: The average follow up was 20.9 months with preoperative ROM was 15.70. The ROM improved to 910 in fresh and 720 in late cases . The result of over- all study shows good result with functional gain in range of movement. Discussion: The surgeon must choose an appropriate treatment based on fracture pattern, joint stability , duration. Stability of the joint is paramount in determining the appropriate treatment, which should aim to facilitate early mobilisation and restoration of function. Conclusion: volar plate arthroplasty gives stable joint and functional range of motion.