Flashcards on Proximal Interphalangeal Joint Injuries and Treatment
PIP Joint Injuries and Treatment: A Student's Guide
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PIP reconstruction and surgery
52 cards
Card 1
Question: What are the three requirements for successful treatment of a post-traumatic PIP joint flexion contracture?
Answer: A nonarthritic joint, a functional extensor mechanism, and a motivated/compliant patient.
Card 2
Question: When should conservative measures be exhausted before operative release of a PIP flexion contracture?
Answer: Dynamic extension splinting and other conservative measures should be exhausted first.
Card 3
Question: What radiographic finding is required before proceeding with surgical release of a PIP flexion contracture?
Answer: A congruent, preserved joint space without mechanical block from osteophytes.
Card 4
Question: Why should flexor pulley integrity be confirmed preoperatively for PIP contracture surgery, and how can it be assessed?
Answer: Pulley rupture can cause PIP contracture; confirm by clinical exam and ultrasound or MRI if suspected.
Card 5
Question: What are the main operative options for post-traumatic PIP flexion contractures described in the text?
Answer: Distraction external fixation and open release/ excision or release of collaterals and/or volar plate.
Card 6
Question: What average extension gains were reported with distraction external fixation for PIP contracture using a unilateral fixator vs a compass hinge fixato
Answer: Unilateral fixator: average 65° gain; compass hinge fixator: average 42° gain.
Card 7
Question: What did Houshian and Chikkamuniyappa find regarding distraction rates and fixator time?
Answer: They found equal results with different distraction rates and showed an accelerated program with an average fixator time of 17 days.
Card 8
Question: What variations in collateral/volar plate release do Abbiati and Mansat/Delprat recommend?
Answer: Abbiati recommended sparing proper collateral ligaments while releasing volar plate and accessory collaterals; Mansat/Delprat recommended releasing vo
Card 9
Question: What did Diao and Eaton report about long-term collateral ligament insufficiency after complete excision of collaterals during joint release?
Answer: They reported no long-term collateral ligament insufficiency after complete excision during joint release.
Card 10
Question: Which surgical approach do the authors prefer for open release of PIP joint contracture and why?
Answer: A Bruner-style volar incision because it allows easier identification of bundles, access to collaterals and volar plate, and permits flexor tenolysis;