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Hemi-hamate arthroplasty vs. second toe osteochondral graft for PIPJ reconstruction: a comparison of outcomes

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Fractures involving the proximal interphalangeal joint (PIPJ) are common injuries, estimated to occur in 9 per 100,000 persons per year [1]. Inadequate treatment of these injuries results in reduced range of motion, arthrosis and pain. The purpose of this study is to compare the functional and clinical outcomes of the hemi-hamate arthroplasty (HHA) and second toe osteochondral graft techniques, both of which can be used to restore the articular surface of the PIPJ after complex fractures.

Methods

We undertook a retrospective cohort study over a 10-year period at one institution from 1/1/2011 to 1/1/2021. Patients were included if they underwent a HHA or second toe osteochondral graft for the management of unstable PIPJ fracture of the index, middle, ring or little finger, with follow-up of 6-month duration or greater. Exclusion criteria included follow-up of less than 6 months, fracture involving 100% of the articular surface or fracture of the thumb PIPJ. Twenty-three grafts were included for analysis.

Results

The second toe osteochondral graft demonstrates similar functional and clinical outcomes to the HHA. The mean postoperative PIPJ range of motion was 63.7° in the HHA group and 55.8° in the second toe group (p = 0.16). There were no statistically significant differences in grip strength. Both techniques demonstrate low rates of complications.

Conclusions

The second toe osteochondral graft technique is a useful addition to the repertoire of the hand surgeon in the reconstruction of complex fracture dislocations of the PIPJ.

Level of evidence: Level III, Therapeutic.

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Data Availability

Data was collected in a password protected Microsoft Excel document, available on request.

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Acknowledgements

The authors would like to acknowledge the Hand Therapy Department at Monash Health due to their collaboration and assistance with data collection.

Funding

The authors declare that no funds, grants or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Plastic and Reconstructive Surgery Department, Monash Health, Melbourne, VIC, Australia

    Sam Hamilton, Nicholas Tang, Geoffrey Lee & James C. S. Leong

Authors
  1. Sam Hamilton
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  2. Nicholas Tang
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  3. Geoffrey Lee
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  4. James C. S. Leong
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Contributions

All authors contributed to the study conception and design. Sam Hamilton and Geoffrey Lee completed data collection. Sam Hamilton and Nicholas Tang completed data analysis. James C. S. Leong provided expert input. The first draft of the manuscript was written by Sam Hamilton, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sam Hamilton.

Ethics declarations

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinski. Ethics approval for this study was obtained from the Monash Health Ethics committee review board (Monash Health Ref: RES-18–0000-496Q).

Consent to participate

Informed consent was not sought for the present study because of its retrospective nature. Data was collected from patient records in a de-identified manner which aligned with the ethics approval that was granted prior to commencing this study.

Competing interests

Sam Hamilton, Nicholas Tang, Geoffrey Lee and James C. S. Leong  declare no competing interests.

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Hamilton, S., Tang, N., Lee, G. et al. Hemi-hamate arthroplasty vs. second toe osteochondral graft for PIPJ reconstruction: a comparison of outcomes. Eur J Plast Surg 46, 409–415 (2023). https://doi.org/10.1007/s00238-022-02034-0

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  • DOI: https://doi.org/10.1007/s00238-022-02034-0

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