Ligamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study

Background Injuries to the proximal interphalangeal (PIP) joint are common and complex. However, the treatment of osteochondral defects of the head of the proximal phalanx has rarely been described. Herein, we propose a new technique for the management of unicondylar defects of the proximal phalanx...

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Autores principales:	Jean-Charles Hery, Baptiste Picart, Mélanie Malherbe, Christophe Hulet, Aude Lombard
Formato:	article
Lenguaje:	EN
Publicado:	Korean Society of Plastic and Reconstructive Surgeons 2021
Materias:	anatomy articular fracture finger collateral ligament reconstruction Surgery RD1-811
Acceso en línea:	https://doaj.org/article/ac91fac1fa2b4f389d3f4fe110f0168e
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spelling	oai:doaj.org-article:ac91fac1fa2b4f389d3f4fe110f0168e2021-11-25T06:04:37ZLigamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study2234-61632234-617110.5999/aps.2021.00220https://doaj.org/article/ac91fac1fa2b4f389d3f4fe110f0168e2021-11-01T00:00:00Zhttp://www.e-aps.org/upload/pdf/aps-2021-00220.pdfhttps://doaj.org/toc/2234-6163https://doaj.org/toc/2234-6171Background Injuries to the proximal interphalangeal (PIP) joint are common and complex. However, the treatment of osteochondral defects of the head of the proximal phalanx has rarely been described. Herein, we propose a new technique for the management of unicondylar defects of the proximal phalanx that can restore joint amplitudes and provide PIP stability. Methods In this cadaveric feasibility study, unicondylar defects were generated using striking wedges and chisels. First, a transverse tunnel measuring 2 mm in diameter passing through the head of the proximal phalanx was made. A second tunnel at the base of the middle phalanx with the same diameter was then created. The hemitendon of the flexor carpi radialis graft was passed through each of these tunnels. The proximal end of the graft was interposed in the area with a loss of bone substance. The ligamentoplasty was then tensed and fixed by two anchors on the proximal phalanx. Joint amplitudes and frontal stability were measured preoperatively and postoperatively. Results There was no significant change in the joint’s range of motion: preoperatively, the mean mobility arcs were –2° to 113.80°, and they were –2° to 110° after the procedure (P=0.999). There was no significant difference in joint stability (P>0.05). Conclusions Ligamentoplasty with PIP interposition appears to be a possible solution for the management of unicondylar defects of the proximal phalanx. An evaluation of clinical results is planned in order to definitively confirm the validity of this procedure.Jean-Charles HeryBaptiste PicartMélanie MalherbeChristophe HuletAude LombardKorean Society of Plastic and Reconstructive Surgeonsarticleanatomyarticular fracturefingercollateral ligament reconstructionSurgeryRD1-811ENArchives of Plastic Surgery, Vol 48, Iss 6, Pp 635-640 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	anatomy articular fracture finger collateral ligament reconstruction Surgery RD1-811
spellingShingle	anatomy articular fracture finger collateral ligament reconstruction Surgery RD1-811 Jean-Charles Hery Baptiste Picart Mélanie Malherbe Christophe Hulet Aude Lombard Ligamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study
description	Background Injuries to the proximal interphalangeal (PIP) joint are common and complex. However, the treatment of osteochondral defects of the head of the proximal phalanx has rarely been described. Herein, we propose a new technique for the management of unicondylar defects of the proximal phalanx that can restore joint amplitudes and provide PIP stability. Methods In this cadaveric feasibility study, unicondylar defects were generated using striking wedges and chisels. First, a transverse tunnel measuring 2 mm in diameter passing through the head of the proximal phalanx was made. A second tunnel at the base of the middle phalanx with the same diameter was then created. The hemitendon of the flexor carpi radialis graft was passed through each of these tunnels. The proximal end of the graft was interposed in the area with a loss of bone substance. The ligamentoplasty was then tensed and fixed by two anchors on the proximal phalanx. Joint amplitudes and frontal stability were measured preoperatively and postoperatively. Results There was no significant change in the joint’s range of motion: preoperatively, the mean mobility arcs were –2° to 113.80°, and they were –2° to 110° after the procedure (P=0.999). There was no significant difference in joint stability (P>0.05). Conclusions Ligamentoplasty with PIP interposition appears to be a possible solution for the management of unicondylar defects of the proximal phalanx. An evaluation of clinical results is planned in order to definitively confirm the validity of this procedure.
format	article
author	Jean-Charles Hery Baptiste Picart Mélanie Malherbe Christophe Hulet Aude Lombard
author_facet	Jean-Charles Hery Baptiste Picart Mélanie Malherbe Christophe Hulet Aude Lombard
author_sort	Jean-Charles Hery
title	Ligamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study
title_short	Ligamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study
title_full	Ligamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study
title_fullStr	Ligamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study
title_full_unstemmed	Ligamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study
title_sort	ligamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study
publisher	Korean Society of Plastic and Reconstructive Surgeons
publishDate	2021
url	https://doaj.org/article/ac91fac1fa2b4f389d3f4fe110f0168e
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Ligamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study

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