Outcomes of Proximal Interphalangeal Joint Fracture-Dislocations Treated with Hemi-hamate Arthroplasty

Background. Proximal phalangeal joint (PIPJ) dorsal fracture-dislocations (DFD) of the proximal interphalangeal joint are complex injuries that are challenging to treat. Hemi-hamate arthroplasty (HHA) is an excellent option in cases when the volar fragment is large and severely comminuted.Objective. The objective of this study was to present the clinical outcome of patients with PIPJ-DFD treated with HHA.Methodology. This case series was a retrospective chart review of all adult patients with PIPJ-DFD treated with HHA between 2015 and 2024. Inclusion criteria included patients with PIPJ-DFD treated with HHA. Patients with multiple digit injuries, open injuries, and associated soft tissue damage were excluded. Primary outcomes measured were the PIPJ arc of motion and the presence of flexion or extension deficits. Secondary outcomes observed include graft healing and post-operative complications.Results. A total of five patients were included in the study. All were male with a mean age of 33.8 years. Four patients had middle finger injuries, and one patient had a ring finger injury. The mean delay to surgery was 2.8 months (range, one week to six months), and the median follow-up was 32 months (range, two to 72 months). The mean volar lip involvement/fragmentation was 50% (range, 40 to 60%). All grafts healed, with a mean PIPJ extension deficit of 25.8° and a mean flexion deficit of 94°. The mean PIPJ arc of motion was 68°. No sensory deficits or pain were reported during use. One case developed radial collateral ligament insufficiency with ulnar subluxation.Conclusion. This case series confirms that HHA is an effective treatment for PIPJ-DFD, yielding satisfactory functional outcomes and reliable graft healing.