Proximal Interphalangeal Finger Arthroplasty with Double Osteochondral Rib Graft. Case Report and Description of the Surgical Technique
Article Sidebar
Published:
Oct 10, 2021
Keywords:
Proximal interphalangeal arthroplasty, osteochondral rib graft.
Main Article Content
Abstract
We present the case of a 27-year-old male patient with a gunshot wound and severe proximal interphalangeal joint injury in the ring finger of the right hand, treated with a double osteochondral rib graft. He had an exposed fracture and a lack of bone and cartilage stock in both the first and second phalanx. After the initial toilette, at 3 weeks, a proximal interphalangeal arthroplasty was performed with a double osteochondral rib graft protected by a Suzuki external distractor. The surgical technique is described in detail. At 10 weeks after surgery, an active interphalangeal joint flexion of 75º and active extension of -15º were verified, without articular instability. The patient returned to work at 3 months after surgery, with no residual pain (0 VAS score) and a DASH score of 14.2. Radiographs showed incorporated grafts without resorption and a congruent joint. This technique is valued for its low morbidity on the donor site and versatility for joint defect reconstructions. The limitations of our study are mentioned. The clinical casepresented obtained a satisfactory subjective and objective early functional outcome. Further complications cannot be ruled out.
Downloads
Download data is not yet available.
Metrics
Metrics Loading ...
Article Details
How to Cite
Gardenal, R. M., Carcuro, R. A., Bichara, J. A., Seri, M. S., Faccendini, S. J., Camizasca, I., Massolas, E., Scaiano, N., Romaldini, M. E., & Godoy, J. I. (2021). Proximal Interphalangeal Finger Arthroplasty with Double Osteochondral Rib Graft. Case Report and Description of the Surgical Technique. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(5), 651-658. https://doi.org/10.15417/issn.1852-7434.2021.86.5.1279
Issue
Section
Case Presentations
Copyright (c) 2021 Revista de la Asociación Argentina de Ortopedia y Traumatología
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
References
1. Satake Y, Nanno M, Kodera N, Takai S. Use of a costal osteochondral graft for reconstruction of a proximal phalanx head with a comminuted fracture of the proximal interphalangeal joint. J Nippon Med Sch 2020;87:37-42.
https://doi.org/10.1272/jnms.JNMS.2020_87-107
2. Lepage D, Tatu L, Loisel F, Rey PB, Obert L, Parratte B. Anatomical and computed tomography study of the eighth costochondral junction: topography for costochondral graft harvesting. Surg Radiol Anat 2016;38(7):809-15. https://doi.org/10.1007/s00276-016-1635-8
3. Sato K, Nakamura T, Nakamichi N, Okuyama N, Yoshiaki TY, Ikegami H. Finger joint reconstruction with costal
osteochondral graft. Tech Hand Up Extrem Surg 2008; 12(3):150-5. https://doi.org/10.1097/BTH.0b013e31816d92ad
4. Loisel F, Pluvy I, Kielwasser H, Panouilleres M, Obert L, Lepage D. Technical note on the harvesting of rib
osteochondral autografts for upper limb bone and joint repair surgery. Hand Surg Rehabil 2018;37(6):337-41.
https://doi.org/10.1016/j.hansur.2018.07.005
5. Suzuki Y, Matsunaga T, Sato S, Yokoi T. The pins and rubbers traction system for treatment of comminuted
intraarticular fractures and fracture-dislocations in the hand. J Hand Surg Br 1994;19(1):98-107.
https://doi.org/10.1016/0266-7681(94)90059-0
6. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH
(disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J
Ind Med 1996; 29(6):602-8. https://doi.org/10.1002/(SICI)1097-0274(199606)29:6<602:AID-AJIM4>3.0.CO;2-L
7. Malerich MM, Eaton RG. The volar plate reconstruction for fracture-dislocation of the proximal interphalangeal
joint. Hand Clin 1994;10(2):251-60. PMID: 8040203
8. Jiménez I, Marcos-García A, Muratore G, Caballero-Martel J, Medina J. Denervation for proximal interphalangeal
joint osteoarthritis. J Hand Surg Am 2020;45(4):358.e1-358.e5. https://doi.org/10.1016/j.jhsa.2019.07.012
9. Wagner ER, Luo TD, Houdek MT, Kor DJ, Moran SL, Rizzo M. Revision proximal interphalangeal arthroplasty: an
outcome analysis of 75 consecutive cases. J Hand Surg Am 2015;40:1949-55. https://doi.org/10.1016/j.jhsa.2015.05.015
10. Wagner ER, Weston JT, Houdek MT, Luo TD, Moran SL, Rizzo M. Medium-term outcomes with pyrocarbon
proximal interphalangeal arthroplasty: a study of 170 consecutive arthroplasties. J Hand Surg Am 2018;43(9):797-
805. https://doi.org/10.1016/j.jhsa.2018.06.020
11. Podolsky D, Mainprize J, McMillan C, Binhammer P. Comparison of third toe joint cartilage thickness to that of the finger proximal interphalangeal (PIP) joint to determine suitability for transplantation in PIP joint reconstruction. J Hand Surg Am 2011;36(12):1950-8. https://doi.org/10.1016/j.jhsa.2011.09.013
12. Leclère FM, Haug L, Meier R, Surke C, Unglaub F, Vögelin E. Non-vascularized partial joint transfer for finger
proximal interphalangeal joint reconstruction: a series of 9 patients. Arch Orthop Trauma Surg 2020;140(1):139-44. https://doi.org/10.1007/s00402-019-03301-9
13. Foucher G, Merle M, Maneaud M, Michon J. Microsurgical free partial toe transfer in hand reconstruction: a report of 12 cases. Plast Reconstr Surg 1980;5:616-27. https://doi.org/10.1097/00006534-198005000-00013
14. Dautel G. Vascularized toe joint transfers to the hand for PIP or MCP reconstruction. Hand Surg Rehabil
2018;37(6):329-36. https://doi.org/10.1016/j.hansur.2018.03.008
15. Millrose M, Zach A, Kim S, Güthoff C, Eisenschenk A, Vonderlind HC. Biomechanical comparison of the proximal interphalangeal joint arthrodesis using a compression wire. Arch Orthop Trauma Surg 2019;139(4):577-81. https://doi.org/10.1007/s00402-019-03119-5
16. Gillies HD. Plastic surgery of the face. London: Oxford University Press; 1920:13-15, 177-182.
17. Hasegawa T, Yamano Y. Arthroplasty of the proximal interphalangeal joint using cartilage grafts. J Hand Surg Br 1992;17:583-5. https://doi.org/10.1016/s0266-7681(05)80248-7
https://doi.org/10.1272/jnms.JNMS.2020_87-107
2. Lepage D, Tatu L, Loisel F, Rey PB, Obert L, Parratte B. Anatomical and computed tomography study of the eighth costochondral junction: topography for costochondral graft harvesting. Surg Radiol Anat 2016;38(7):809-15. https://doi.org/10.1007/s00276-016-1635-8
3. Sato K, Nakamura T, Nakamichi N, Okuyama N, Yoshiaki TY, Ikegami H. Finger joint reconstruction with costal
osteochondral graft. Tech Hand Up Extrem Surg 2008; 12(3):150-5. https://doi.org/10.1097/BTH.0b013e31816d92ad
4. Loisel F, Pluvy I, Kielwasser H, Panouilleres M, Obert L, Lepage D. Technical note on the harvesting of rib
osteochondral autografts for upper limb bone and joint repair surgery. Hand Surg Rehabil 2018;37(6):337-41.
https://doi.org/10.1016/j.hansur.2018.07.005
5. Suzuki Y, Matsunaga T, Sato S, Yokoi T. The pins and rubbers traction system for treatment of comminuted
intraarticular fractures and fracture-dislocations in the hand. J Hand Surg Br 1994;19(1):98-107.
https://doi.org/10.1016/0266-7681(94)90059-0
6. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH
(disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J
Ind Med 1996; 29(6):602-8. https://doi.org/10.1002/(SICI)1097-0274(199606)29:6<602:AID-AJIM4>3.0.CO;2-L
7. Malerich MM, Eaton RG. The volar plate reconstruction for fracture-dislocation of the proximal interphalangeal
joint. Hand Clin 1994;10(2):251-60. PMID: 8040203
8. Jiménez I, Marcos-García A, Muratore G, Caballero-Martel J, Medina J. Denervation for proximal interphalangeal
joint osteoarthritis. J Hand Surg Am 2020;45(4):358.e1-358.e5. https://doi.org/10.1016/j.jhsa.2019.07.012
9. Wagner ER, Luo TD, Houdek MT, Kor DJ, Moran SL, Rizzo M. Revision proximal interphalangeal arthroplasty: an
outcome analysis of 75 consecutive cases. J Hand Surg Am 2015;40:1949-55. https://doi.org/10.1016/j.jhsa.2015.05.015
10. Wagner ER, Weston JT, Houdek MT, Luo TD, Moran SL, Rizzo M. Medium-term outcomes with pyrocarbon
proximal interphalangeal arthroplasty: a study of 170 consecutive arthroplasties. J Hand Surg Am 2018;43(9):797-
805. https://doi.org/10.1016/j.jhsa.2018.06.020
11. Podolsky D, Mainprize J, McMillan C, Binhammer P. Comparison of third toe joint cartilage thickness to that of the finger proximal interphalangeal (PIP) joint to determine suitability for transplantation in PIP joint reconstruction. J Hand Surg Am 2011;36(12):1950-8. https://doi.org/10.1016/j.jhsa.2011.09.013
12. Leclère FM, Haug L, Meier R, Surke C, Unglaub F, Vögelin E. Non-vascularized partial joint transfer for finger
proximal interphalangeal joint reconstruction: a series of 9 patients. Arch Orthop Trauma Surg 2020;140(1):139-44. https://doi.org/10.1007/s00402-019-03301-9
13. Foucher G, Merle M, Maneaud M, Michon J. Microsurgical free partial toe transfer in hand reconstruction: a report of 12 cases. Plast Reconstr Surg 1980;5:616-27. https://doi.org/10.1097/00006534-198005000-00013
14. Dautel G. Vascularized toe joint transfers to the hand for PIP or MCP reconstruction. Hand Surg Rehabil
2018;37(6):329-36. https://doi.org/10.1016/j.hansur.2018.03.008
15. Millrose M, Zach A, Kim S, Güthoff C, Eisenschenk A, Vonderlind HC. Biomechanical comparison of the proximal interphalangeal joint arthrodesis using a compression wire. Arch Orthop Trauma Surg 2019;139(4):577-81. https://doi.org/10.1007/s00402-019-03119-5
16. Gillies HD. Plastic surgery of the face. London: Oxford University Press; 1920:13-15, 177-182.
17. Hasegawa T, Yamano Y. Arthroplasty of the proximal interphalangeal joint using cartilage grafts. J Hand Surg Br 1992;17:583-5. https://doi.org/10.1016/s0266-7681(05)80248-7