Article
Outcome of modified hemihammate arthroplasty in patients presenting after six weeks of injury
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Authors
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Mohammed Tahir Ansari
- All India Institute of Medical Sciences, Delhi, India
| Published: | February 6, 2020 |
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Outline
Text
Objectives/Interrogation: To assess the functional and radiological outcome of modified hemihammate arthroplasty in patients presenting after six weeks of injury
Methods: This is retrospective study included 7 patients presented to us between Jan 2015 to Jan2018 with comminuted and or displaced (unstable) palmer lip fracture. Mode of injury was sports in 3, road traffic accident in 2 and fall in 2 patients. Shotgun approach was used in all patients. Average middle phalangeal articular involvement was 62% on CT scan while volar lip involvement was 60%. In all patients we have used hemihamate autograft and fixed with 2 1.3 mm ao screw. Average timing of presentation was 12 weeks (8-15). Average time to surgery was 85 days (60-110). Range of motion, stability, and grip strength were measured at a mean follow-up evaluation of 12 months. Radiographs were evaluated for union, graft incorporation, and/or collapse.
Results: All the patients had average of 90 degree of flexion at PIP and average of 60 degree of flexion at DIP. There was an average of 5 degree of extension lag. In all patients pain was not a complaint in follow up rather swelling persisted for long and took 6-8 month to resolve. All patients had bony union in follow up and grip strength was 80% of normal side. They were able to return their daily routine on average 3 month post surgery. 6 patients were very satisfied while one is satisfied.
Conclusion: Hemi hamate arthroplasty with modification in surgical technique is one of the reliable and reproducible surgical option for reconstruction of the articular surface of the base of middle phalanx in patients of fracture dislocation of the PIP joint who present late.
