Management of a proximal interphalangeal joint fracture dislocation with a compass proximal interphalangeal joint hinge and therapy: a case report.

The purpose of this report is to describe the management of a chronic proximal interphalangeal (PIP) joint fracture dislocation in a 46-year-old computer programmer. Twenty days following injury, a right ring finger volar plate arthroplasty was performed, loose fracture fragments were excised, and a...

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Publicado en:Journal of Hand Therapy Vol. 15; no. 3; pp. 266 - 274
Autores principales: Feldscher SB, Blank JE
Formato: case study pictorial tables/charts Journal Article
Publicado: Elsevier B.V. 2002 Jul-Sep
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2002 Jul-Sep
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      pub: Elsevier B.V.
      place: Philadelphia, Pennsylvania
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        atl: Management of a proximal interphalangeal joint fracture dislocation with a compass proximal interphalangeal joint hinge and therapy: a case report.
      aug:
        au:
          Feldscher SB
          Blank JE
        affil: Hand Specialist, Hamilton Physical Therapy Services, The Philadelphia Hand Center, Southern, New Jersey
      sug:
        subj:
          Fractures Therapy
          Dislocations Therapy
          Finger Injuries Therapy
          Splints Utilization
          Middle Age
          Male
          Arthroplasty
          Orthopedic Fixation Devices
          Treatment Outcomes
          Range of Motion
          Middle Aged: 45-64 years
          Male
      ab: The purpose of this report is to describe the management of a chronic proximal interphalangeal (PIP) joint fracture dislocation in a 46-year-old computer programmer. Twenty days following injury, a right ring finger volar plate arthroplasty was performed, loose fracture fragments were excised, and a Compass PIP joint hinge was applied. The hinge was locked at 10 degrees to 15 degrees extension and held in this position for 8 days. On postoperative day 8, hand therapy was initiated. Many challenges were encountered. Insurance constraints required the patient to change therapists. The device frame cracked. The patient developed a PIP joint contracture with extensor lag. Despite these obstacles, the patient achieved a successful outcome, returning to normal pain-free use with grip strength at 87% of that of the uninvolved hand. At discharge, active range of motion was 12 degrees/100 degrees at the PIP joint and 0 degrees/40 degrees at the DIP joint. Passive extension was 0 degrees. At 6 months postoperatively, active range of motion was 0 degrees/105 degrees at the PIP joint and 0 degrees/60 degrees at the DIP joint. This case demonstrates the need for closely supervised postoperative therapy that includes good communication between providers, ongoing patient education, and close monitoring of range of motion.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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