TY - JOUR
T1 - The Central Slip Fracture
T2 - Results of Operative Treatment of Volar Fracture Subluxations/Dislocations of the Proximal Interphalangeal Joint
AU - Meyer, Zachary I.
AU - Goldfarb, Charles A.
AU - Calfee, Ryan P.
AU - Wall, Lindley B.
N1 - Publisher Copyright:
© 2017 American Society for Surgery of the Hand
PY - 2017/7
Y1 - 2017/7
N2 - Purpose Fractures of the base of the middle phalanx are particularly challenging. Dorsal fracture-subluxations/dislocations of the proximal interphalangeal (PIP) joint are relatively common, but the volar fracture-subluxation/dislocation, the so-called “central slip fracture,” is quite rare. The current study presents our experience with surgically treated patients with central slip fracture subluxation/dislocation with a minimum of 1 year follow-up. We hypothesized that the majority of patients with a central slip fracture-subluxation/dislocation have poor outcomes. Methods Thirteen patients with central slip fracture-subluxations/dislocation were identified from departmental billing records between 2003 and 2013. Nine patients completed the study follow-up examination and 8 were included in the final analysis. Clinical data assessed included age at injury, sex, mechanism of injury, injured digit, type of treatment, additional intervention(s), complications, length of follow-up, and range of motion follow-up. Fluoroscopic images and Quick Disabilities of the Arm, Shoulder, and Hand surveys were obtained at study follow-up. Results All patients underwent at least 1 surgery and 7 of 8 underwent open reduction. The average age at the time of injury was 41 years (range, 25–60 years). All injuries were closed. The average follow-up was 43 months (range, 17–67 months). Average passive and active range of motion of the PIP joint at follow-up were 62° and 54°, respectively. Six of 8 patients developed radiographic evidence of arthritic change and 4 experienced an outcome that required additional interventions. Conclusions Patients should be counseled about the outcomes following surgical treatment of this uncommon, difficult injury. Type of study/level of evidence Therapeutic V.
AB - Purpose Fractures of the base of the middle phalanx are particularly challenging. Dorsal fracture-subluxations/dislocations of the proximal interphalangeal (PIP) joint are relatively common, but the volar fracture-subluxation/dislocation, the so-called “central slip fracture,” is quite rare. The current study presents our experience with surgically treated patients with central slip fracture subluxation/dislocation with a minimum of 1 year follow-up. We hypothesized that the majority of patients with a central slip fracture-subluxation/dislocation have poor outcomes. Methods Thirteen patients with central slip fracture-subluxations/dislocation were identified from departmental billing records between 2003 and 2013. Nine patients completed the study follow-up examination and 8 were included in the final analysis. Clinical data assessed included age at injury, sex, mechanism of injury, injured digit, type of treatment, additional intervention(s), complications, length of follow-up, and range of motion follow-up. Fluoroscopic images and Quick Disabilities of the Arm, Shoulder, and Hand surveys were obtained at study follow-up. Results All patients underwent at least 1 surgery and 7 of 8 underwent open reduction. The average age at the time of injury was 41 years (range, 25–60 years). All injuries were closed. The average follow-up was 43 months (range, 17–67 months). Average passive and active range of motion of the PIP joint at follow-up were 62° and 54°, respectively. Six of 8 patients developed radiographic evidence of arthritic change and 4 experienced an outcome that required additional interventions. Conclusions Patients should be counseled about the outcomes following surgical treatment of this uncommon, difficult injury. Type of study/level of evidence Therapeutic V.
KW - Central slip fracture
KW - proximal interphalangeal joint dislocation
UR - http://www.scopus.com/inward/record.url?scp=85018967025&partnerID=8YFLogxK
U2 - 10.1016/j.jhsa.2017.03.030
DO - 10.1016/j.jhsa.2017.03.030
M3 - Article
C2 - 28476538
AN - SCOPUS:85018967025
SN - 0363-5023
VL - 42
SP - 572.e1-572.e6
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
IS - 7
ER -