Release notes of Hand - Middle phalanges

The content has been revised by Aida García (CO) with Simon Lambert (UK) as executive editor. Inese Breide (LV) acted as a reviewer.

The main differences to the first edition are:

• Update of plating procedures to VA locking plates

• Addition of dynamic external fixation
• Addition of postoperative healing phases
• Addition of patient assessment
• Addition of complications and technical failures
• Addition of cases

Several approach and procedure videos have been added:

• Dorsal approach to the PIP joint
• Dorsal approach to the middle phalanx
• Midaxial approach to the middle phalanx
• Extension Block Splint (Burke Halter)

The middle phalangeal material of the hand, second edition, includes a detailed description of the following injury types and their management.

Dislocation of the proximal interphalangeal joint:

• Nonoperative treatment
• Collateral ligament repair

Dorsal avulsion of the proximal end segment:

• Nonoperative treatment
• Extensor block pinning
• Lag-screw fixation
• Cerclage compression wiring
• Central slip reattachment

Collateral ligament avulsion of the proximal end segment:

• Nonoperative treatment
• Lag-screw fixation
• Cerclage compression wiring
• Collateral ligament reattachment

Volar plate avulsion of the proximal end segment:

• Nonoperative treatment
• Lag-screw fixation
• Volar plate reattachment

Multifragmentary articular fracture of the proximal end segment:

• Volar plate arthroplasty
• Hemihamate arthroplasty with osteocartilaginous graft
• Joint reconstruction of a palmar impaction fracture
• Joint reconstruction of a lateral plateau fracture
• Joint reconstruction of a central impaction fracture
• Plate fixation of pilon compression fracture
• Dynamic external traction

Oblique extraarticular or diaphyseal fracture:

• Nonoperative treatment
• K-wire fixation
• Lag-screw fixation
• Compression plating

Transverse extraarticular or diaphyseal fracture:

• Nonoperative treatment
• K-wire fixation
• Compression plating

Multifragmentary extraarticular or diaphyseal fracture:

• Nonoperative treatment
• Bridge plating
• Lag-screw and plate fixation

Partial articular fracture of the distal end segment:

• Nonoperative treatment
• K-wire fixation
• Lag-screw fixation

Complete articular fracture of the distal end segment:

• Nonoperative treatment
• K-wire fixation
• Lag-screw fixation

Dislocation of the distal interphalangeal joint:

• Nonoperative treatment
• Joint transfixation with K-wire

Approaches:

• Dorsal approach to the PIP joint
• Dorsal approach to the middle phalanx
• Midaxial approach to the middle phalanx
• Midaxial (lateral) approach to the proximal interphalangeal joint
• Palmar approach to the proximal interphalangeal joint
• Dorsal approach to the carpometacarpal joint

Further material:

• Supine patient position
• Assessment of middle phalangeal injuries of the hand
• Complications and technical failures
• References

The content has been created by Renato Fricker (CH), Matej Kastelec (SI), Fiesky Nuñez (VE), and Terry Axelrod (CA) with Chris Colton (UK) as executive editor.

The middle phalangeal material of the hand, first edition, included a detailed description of the following injury types and their management.

Distal, unicondylar:

• Nonoperative treatment
• Lag screw fixation

Distal, bicondylar:

• Nonoperative treatment
• Lag screw fixation

Shaft, transverse:

• Nonoperative treatment
• K-wire fixation
• Compression plate fixation

Shaft, oblique:

• Nonoperative treatment
• Lag screw fixation

Shaft, multifragmentary:

• Nonoperative treatment
• Minicondylar bridge plate fixation

Proximal, dislocation:

• Collateral ligament repair

Proximal, dorsal avulsion fracture:

• Dorsal lag screw fixation
• Cerclage compression wiring

Proximal, collateral ligament avulsion:

• Lag screw fixation
• Cerclage compression wiring

Proximal, volar plate avulsion:

• Lag screw fixation of volar plate
• Suture fixation
• Volar plate arthroplasty

Proximal, multifragmentary:

• Hemi-hamate arthroplasty with bone graft
• Joint reconstruction with bone graft
• Minicondylar plate fixation of Pilon compression fracture
• Screw fixation of lateral plateau compression fracture
• Screw fixation with bone graft of central impaction fracture

Approaches:

• Midaxial approach to the middle phalanx
• Dorsal approach to the middle phalanx
• Palmar approach to the PIP joint
• Midaxial approach to the PIP joint
• Dorsal approaches to the PIP joint