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J Wrist Surg 2023; 12(04): 371-376
DOI: 10.1055/s-0042-1749658
Emerging Technologies and New Technological Concepts

Press-Fit Hemihamate Arthroplasty for the Proximal Interphalangeal Joint

Hiroaki Takeya
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Takuji Iwamoto
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Hiroo Kimura
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Taku Suzuki
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Noboru Matsumura
1   Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Tetsuji Hosozawa
2   Department of Orthopaedic Surgery, Saitama Municipal Hospital, Saitama, Japan
,
Shohei Iwabu
3   Department of Orthopedic Surgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan
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Abstract

Background Chronic proximal interphalangeal joint fracture-dislocations with articular malunion are complex injuries. Hemihamate arthroplasty is an established technique for the management of both acute and chronic cases but is associated with several complications. We present the clinical experience of modified press-fit hemihamate arthroplasty.

Description of Technique The base of the middle phalanx was exposed from the volar side, and the cartilage defect of the proximal interphalangeal joint (PIPJ) was evaluated in the hyperextended position. A bone hole was created slightly toward the volar side to recreate the curvature of the PIPJ. The hemihamate osteochondral graft was harvested and fixed into the bone hole in a press-fit manner without using a screw. The volar plate and flexor tendon sheath were then reattached.

Patients and Methods The study included three patients with chronic dorsal fracture-dislocations of the PIPJ. All patients were treated for >6 weeks after the injury (average 11 weeks).

Results The average total arc of motion of the affected joint improved from 38 degrees before surgery to 80 degrees after surgery. Radiographically, bone union and congruity of the joint surface were achieved in all the patients. None of the treated patients complained of resting pain and reported minimal pain during activity (average visual analog scale 0.5; range 0–1.4).

Conclusions Press-fit hemihamate arthroplasty is a safe and effective procedure for treating chronic PIPJ fracture-dislocations without the risk of screw protrusion.

Keywords

proximal interphalangeal joint - hemihamate arthroplasty - osteochondral graft

Note

This work was performed at Saitama Municipal hospital, Saiseikai Utsunomiya Hospital and Keio University School of Medicine.




Publication History

Received: 24 February 2022

Accepted: 20 April 2022

Article published online:
12 July 2022

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