Functional outcomes following delayed hemi-hamate arthroplasty for proximal interphalangeal joint reconstruction

Abstract

Palmar lip fractures at the base of the middle phalanx are well-regarded as a difficult condition to treat, with many treatment strategies leading to pain and impairment. Hemi-hamate resurfacing arthroplasty for the proximal interphalangeal joint surface has been described in the literature as a surgical option in the management of this fracture type. This case series aims to describe our institution’s experience with hemi-hamate arthroplasty for this type of fracture. Six patients from a single institution who underwent hemi-hamate arthroplasty for treatment of impacted dorsal fracture dislocations of the base of the middle phalanx between 2014 and 2018 were retrospectively reviewed. Four patients were managed at a time frame greater than 100 days, with a range between 32 and 50% of articular joint involvement. Functional outcomes and pain scores following hemi-hamate arthroplasty in both acute and chronic presentations resulted in adequate range of motion and grip strength, with minimal pain at either fracture or donor site. No cases of non-union were seen in our cohort. Based on our experience, hemi-hamate arthroplasty is a viable option in the management of intra-articular fracture dislocations of the base of the middle phalanx. Level of evidence: Level IV, therapeutic study.