[Post-acute management of fractures of the proximal interphalangeal joint with metal prosthesis: first experience].

AIM: The purpose of this report is to present our management strategy for fractures of the proximal interphalangeal joint by means of a metal prosthesis via a dorsomedial approach and to discuss our clinical and radiological results.

PATIENTS AND

METHODS

Two patients with complex crush injuries and fractures of the proximal interphalangeal joints who were treated surgically in the years 2004 and 2005 were examined again at an average of 13 months postoperatively. Management was standardised, first in the emergency room with wound cleaning and temporary osteosynthesis. About 3-4 weeks later a secondary procedure with implantation of a metallic prosthesis was carried out. Clinical and radiological follow-ups were performed. The final result was evaluated by means of the modified Mayo wrist score. In addition, the patients' functional limitations were assessed quantitatively with the DASH evaluation scheme.

RESULTS

In one of the two patients, revision surgery in the form of a definitive arthrodesis was necessary. Grip strength on the injured side was weakened by 10 %. One patient achieved a very good and the other a good result upon evaluation with the modified Mayo wrist score. The DASH evaluation gave on average a functional limitation of 30 points.