Reconstruction of the middle phalangeal base of the finger using an osteocartilaginous autograft from the hamate

Operative Orthopädie und Traumatologie
T PillukatJ van Schoonhoven

Abstract

Restoration of proximal interphalangeal joint stability with preservation of mobility by reconstruction of the middle phalanx base using an osteochondral graft from the carpometacarpal joint surface of the hamate. Acute and older isolated destruction of the palmar middle phalanx base >25%. Destruction of the head of the proximal phalanx, advanced chondropathia of the head of the proximal phalanx, extensive soft tissue injury with loss of skin coverage at the proximal interphalangeal joint. The fractured middle phalangeal base is debrided and the defect is replaced by a size-matched autograft from the dorsal carpometacarpal hamate osteoarticular surface that is secured in place with miniscrews. Immobilization for 2 weeks in a below-elbow cast in intrinsic plus position. Subsequent immobilization by a splint including the distal and proximal interphalangeal joint. Healing was achieved in 100% with restoration of joint congruity in 12 of 13 cases and slight subluxation in 1 case. Follow up was possible in 9 cases after 22 ± 16 (5-51) months. The average range of motion in the reconstructed joint achieved 0/9/73°, grip strength 82% of the unaffected side. Of the 9 patients, 5 developed a mild flexion contracture of the proximal int...Continue Reading

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Nov 7, 2019·Archives of Orthopaedic and Trauma Surgery·Franck M LeclèreEsther Vögelin
Nov 25, 2018·Archives of Orthopaedic and Trauma Surgery·Ji Hun ParkJong Woong Park
Feb 8, 2021·Archives of Orthopaedic and Trauma Surgery·C K SpiesJ Oppermann

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