Hemi-hamate arthroplasties for proximal interphalangeal joint fracture dislocations: long-term follow-up in acute, subacute and chronic cases

Hemihamate arthroplasty (HHA) method is one of the recommended treatment methods for unstable proximal interphalangeal joint (PIPJ) fracture dislocations The primary goal of this method is to achieve a stable and well-aligned joint by reconstructing the palmar lip. The aim of this study is to present mid to long term results of patients treated with HHA method in the acute, subacute and chronically. 22 patients was operated with this technique by single surgeon between 2013 and 2025. Patients were classified as acute (< 3 weeks), subacute (3–6 weeks), and chronic (> 6 weeks) based on the time elapsed between the date of injury and the date of surgery. Patients were assessed clinically, radiologically and subjectively. The mean ROM of the PIPJ was 80.6° (20–100°), the flexion was 91.6° (65–100), and the extension lag was 11° (0–50). Grip strength on the operated side was 91.7% of the average on the unaffected side (74–110). The mean rest pain score according to the VAS (0 least-10 most) was 0.6 (0–3), and the activity pain score was 2 (0–5). The mean Q-DASH scores assessing functional level were 9.55 and the mean Mayo scores were 81.4. When patients were asked about their satisfaction after surgery, 12 patients responded very good, two patients good, and four patients moderate. With HHA, reasonable PIPJ ROM and good functional outcomes were achieved. With increased PIP ROM, functional outcomes statistically significantly improved. Thanks to hemihamate arthroplasty, successful results can be achieved even in cases where almost the entire joint surface is affected. Hemihamate arthroplasty method provides good functional results even in chronic injuries lasting up to a year, as in acute injuries. IV.