Abstract

MARQUES, Carla; ALVES, Sandra; SANTOS, Cláudia  and  ESTEVES, Nuno. Artroplastia total no tratamento de fraturas complexas da articulação interfalângica proximal da mão: A propósito de um caso clínico. Rev. Port. Ortop. Traum. [online]. 2017, vol.25, n.2, pp.121-128. ISSN 1646-2122.

Introduction: Although common, fractures of the proximal interphalangeal joints (PIPJ) are often underdiagnosed. In addition to the delay in presentation and the complex diagnosis, treatment turns out to be truly challenging, particularly when dealing with higher degrees of comminution and instability. In these cases, the risk of long term complications may demand the use of advanced reconstructive techniques. Most reports concerning PIPJ reconstruction, however, are restricted to the treatment of chronic arthritic lesions. Case Report: This article describes the clinical case of a 25 year-old male who, following a fall, presented with complex 4^th finger’s PIPJ fracture of the right (dominant) hand, documented clinically and radiologically. Treatment steps are described - initially using traction techniques, and, at last, total arthroplasty using a modular metal-plastic implant - as well as postoperative evolution during a 6 month follow-up. Aim / Discussion: This study has the purpose of establishing a comparative view between arthroplasty and arthrodesis, accounting for the indications, advantages and disadvantages of both techniques. Conclusion: Arthroplasty of the PIPJ has been standing out as a good alternative to arthrodesis, mainly due to its role in the preservation of joint mobility. The need of developing treatment protocols and optimizing the results of the described technique justifies the design of prospective studies, with broader sample sizes and follow-up periods.

Keywords : Intra-articular fractures; proximal interphalangeal joint; hand; arthroplasty.

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