The management of acute fracture dislocations of proximal interphalangeal joints: a systematic review

Abstract

A systematic review was conducted to identify the best management for acute proximal interphalangeal joint fracture-dislocations. A study protocol was designed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Due to limited data in the primary assessment, the hypothesis was tested in a secondary analysis of articles that marginally met the inclusion criteria (i.e. studies that included patients under 18 years of age). A further tertiary analysis was conducted by dividing the studies into closed reduction techniques, open reduction internal fixation and ‘other studies’ and a narrative synthesis was performed. The study found a higher rate of complications and arthritis in the closed reduction group compared to open reduction internal fixation, suggesting that operative management should be considered for acute PIP joint fracture-dislocations.

Level of evidence

III.

Keywords:

• PIP joint
• proximal interphalangeal
• fracture-dislocation
• management

Acknowledgements

The authors would like to thank Prof. Julie Morris, head of Medical Statics at University Hospital of South Manchester for her help with data analysis.

Disclosure statement

The authors declared no potential conflicts of interests with respect to the research, authorship and/or publication of this article.