To explore the feasibility and clinical efficacy of treatment of chronic proximal interphalangeal joint(PIPJ) fracture and dislocation with hemi-hamate arthroplasty and extensor release.

A retrospective study of 7 patients with old metacarpal base fracture and dislocation of the middle phalanx (4 cases from Beijing Jishuitan Hospital and 3 cases from Beijing Chaoyang Integrative Medicine Emergency Medical Center) was conducted. According to the size of the defect of the articular surface of the middle phalangeal bone, the semi-uncinate bone was cut and transplanted and fixed with steel plate according to the size of the defect of the articular surface of the middle phalangeal bone. Postoperative follow-up and statistics were carried out from the aspects of pain, active range of motion of the affected finger proximal interphalangeal joint and fracture healing time, and the main points of intraoperative operation and clinical effect were analyzed and discussed. The data was analyzed by paired sample t test.

The average follow-up was (7.4±2.3) months. After operation, the wound all primarily healed. All fractures healed with a smooth joint surface with an average of (2.7±0.7) months. The patients were encouraged to begin active ROM exercises after 2 days postoperatively. The visual analog scale values before and after the operation were (4.3±1.1) points and (0.9±0.7) points. The pre- and post-operational active ROM was (35.7±11.3)° and (83.6±14.6)°. Both the differences were statistically significant (P<0.01). There was only slightly active extension limit with (7.1±10.7)°.

Sufficient extensor release is greatly beneficial not only to the intraoperative reduction of the PIPJ but also to the postoperative ROM exercises. It can be one of the best choices to combined with the hemi-hamate arthroplasty for the chronic PIPJ fracture and dislocation.