Hand and wrist fracture

--Volar plating of proximal third of proximal phalanx:

Phalangeal fractures, especially those of the proximal phalanx, account for approximately 25% of hand and wrist fractures. Plating is generally associated with severe tendon-related complications and unsatisfactory hand function. Recently, volar plating has been used to fix intra-articular fractures at the base of the proximal phalanx, and it has been reported to result in excellent finger motion and grip strength. We proposed that volar plating has a lower risk of tendon irritation compared to dorsal plating due to the larger tendon-to-bone distances on the volar side. The purpose of this study was to: 1) present the surgical outcomes of 9 cases of extra-articular fractures in the proximal third of the proximal phalanx treated with volar plating, and 2) compare the tendon-to-bone distances between the volar and dorsal sides of the proximal phalanx.

--Unsolving problem for PIPJ fracture dislocation

Intra-articular fracture-dislocation of the proximal interphalangeal (PIP) joint has been a challenging problem for hand surgeons. It encompass a spectrum of injury severity, ranging from ligament tear, bony fracture to cartilage destruction. Therefore, treatment was individually depended on its injury personality. Acceptable outcome is dependent on achieving and maintaining a well-aligned and well-reduced joint, re-establishing normal joint kinematics, and restoring motion. Anatomic articular surface reduction is desirable but not absolutely necessary for a good outcome. There have been many techniques described in the literature to treat this difficult condition such as extension block splint, pinning, dynamic traction systems with pins and rubber, volar plate arthroplasty, internal fixation of fracture and hemi-hamate arthroplasty. Many of them are technically demanding. We present results treated with different technique and early mobilization protocol.