2Ĭurrent treatment modalities are open reduction, percutaneous fixation, dynamic external fixation, extension block pinning, and hemi-hamate arthroplasty. These potential complications result in a hand injury that has historically been difficult to treat. Furthermore, PIPJ fracture-dislocations with suboptimal treatment can present as chronic joint instability, pain, osteoarthritis, and intra-articular deformity. PIPJ fracture-dislocations can result in significant digit range of motion (ROM) limitation and subsequent occupational disability. The proximal interphalangeal joint (PIPJ) accounts for approximately 85% of joint motion that enables grasping an object, 1 thus fracture-dislocations or fracture-subluxations can have an immense impact upon hand utility. No treatment method or fracture type yielded consistently better outcomes than another. While dorsal fracture-dislocations produced higher average ROM and lower QuickDASH score, pilon fractures produced a higher grip strength. Conclusion: Percutaneous fixation yielded the highest post-operative ROM at final follow-up while extension-block pinning resulted in the greatest grip strength. Dorsal fracture-dislocations, regardless of surgical method, had an average ROM of 83.2 (n = 321), grip strength 91% (n = 132), and QuickDASH of 6.6 (n = 59) while pilon injuries had an average ROM of 80.2 (n = 48), grip strength 100% (n = 13), and QuickDASH of 11.4 (n = 13). The weighted means of post-operative range of motion (ROM degrees) at final follow-up were open reduction 84.7 (n = 146), percutaneous fixation 86.5 (n = 32), dynamic external fixation 81.7 (n = 389), extension-block pinning 83.6 (n = 85), and hemi-hamate arthroplasty 79.3 (n = 52). Results: Forty-eight of 1679 total screened articles were included. Articles were distributed into 5 groups by surgical method: open reduction, percutaneous fixation, dynamic external fixation, extension-block pinning, and hemi-hamate arthroplasty. Outcomes of interest included PIPJ range of motion, grip strength (% of contralateral hand), and quick disabilities of arm, shoulder, hand (QuickDASH). Methods: A literature review of PubMed and EMBASE databases was performed for all articles on PIPJ fracture-dislocations. The purpose of this systematic review of the literature is to report the post-operative outcomes of multiple treatment modalities for PIPJ fracture-dislocations in various studies. Several surgical methods have been utilized for management of these injuries, none of which have shown consistently favorable results. Background: Treatment of proximal interphalangeal joint (PIPJ) fracture-dislocations is difficult given the potential long-term complications of the involved finger and entire hand.
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