290 likes | 525 Views
hand PIP JOINT. Posterior Fracture Dislocation Dr H.Saeed M.D. TUMS congress March 2010. PIP JOINT. anatomical and functional locus of finger function. Anatomy. Anatomy. 3d Ligament-box complex. Anatomy.
E N D
hand PIP JOINT Posterior Fracture Dislocation Dr H.Saeed M.D. TUMS congress March 2010 Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
PIP JOINT anatomicalandfunctional locus of fingerfunction Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Anatomy Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Anatomy 3dLigament-boxcomplex Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Anatomy Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Dislocations Dorsal Lateral volar Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
DorsalDislocations Type I hyperextention Type II dorsaldislocation Type III fracture-dislocation Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
DorsalDislocations Type I Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
DorsalDislocations Type II Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
DorsalDislocations Type III Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
DorsalDislocations Type III • stable • unstable Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
DorsalDislocations Type III • stable Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
DorsalDislocations Type III • unstable Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Clinical evaluation Activestability Passivestability Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Radiographic evaluation Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Treatment(type I) no more than one week immobilization Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Treatment(type II) no more than 2-3 weeks immobilization Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Treatment(type III-stable) Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Treatment(type III-unstable) • Extension block splinting • Extension block pining • Dynamic skeletal traction • Open reduction and internal fixation • Hemihamateautograft • Volar plate arthroplasty Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
TreatmentExtension block splinting Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
TreatmentExtension block pining Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
TreatmentDynamic skeletal traction Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
TreatmentDynamic skeletal traction Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
TreatmentOpen reduction and internal fixation Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
TreatmentHemihamateautograft Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
TreatmentVolar plate arthroplasty Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Complications • Redisplacement • Angulation • Flexion contracture • DIP stiffness Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010
Outcome PIPflexioncontracture Posterior fx-dx of hand PIP joint , Dr H.Saeed M.D. ,Tehran POTA congress 2010