Case ReportNo Access

Use of a Box-cut Osteotomy Preserving Collateral Ligaments in Costal Osteochondral Graft Reconstruction of Proximal Interphalangeal Joint Cartilage Defects

Department of Orthopaedic Surgery, Iizuka Hospital, 3-83, Yoshio Town, Iizuka City, Fukuoka Prefecture, Japan

E-mail Address: ushishi@ortho.med.kyushu-u.ac.jp

Correspondence to: Takahiro Ushijima, Department of Orthopaedic Surgery Iizuka Hospital, 3-83, Yoshio Town, Iizuka City, Fukuoka Prefecture 820-8505, Japan. Tel: +81-948-22-3800, Fax: +81-948-29-8747.

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and

Ken ARAI

Department of Orthopaedic Surgery, Iizuka Hospital, 3-83, Yoshio Town, Iizuka City, Fukuoka Prefecture, Japan

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https://doi.org/10.1142/S2424835522720158Cited by:0 (Source: Crossref)

Abstract

We report two patients with reconstruction of osteochondral defects of the proximal interphalangeal joint (PIPJ) using a costal osteochondral graft (COG). A box-cut osteotomy was done at the end of the phalanx preserving the lateral cortices and the insertion of the collateral ligaments. A COG was harvested from the rib, moulded and press fit into the groove formed by the box-cut osteotomy. The COG was fixed with mini screws in the coronal plane (dorsal to palmar) and the fixation off-loaded with an external fixator. This technique maintained the collateral ligament in-situ and is useful in reconstruction of chondral defects of the PIPJ.

Level of Evidence: Level V (Therapeutic)

Keywords:

REFERENCES

1. Woodworth JA, McCullough MB, Grosland NM, Adams BD. Impact of simulated proximal interphalangeal arthrodesis of all fingers on hand function. J Hand Surg Am. 2006;31(6):940–946. https://doi.org/10.1016/j.jhsa.2006.03.008. Crossref, Google Scholar
2. Vitale MA, Fruth KM, Rizzo M, Moran SL, Kakar S. Prosthetic arthroplasty versus arthrodesis for osteoarthritis and posttraumatic arthritis of the index finger proximal inter phalangeal joint. J Hand Surg Am. 2015;40(10):1937–1948. https://doi.org/10.1016/j.jhsa.2015.05.021. Crossref, Google Scholar
3. Tsubokawa N, Yoshizu T, Maki Y. Long-term results of free vascularized second toe joint transfers to finger proximal interphalangeal joints. J Hand Surg Am. 2003;28(3):443–447. https://doi.org/10.1053/jhsu.2003.50087. Crossref, Google Scholar
4. Hasegawa T, Yamano Y. Arthroplasty of the proximal interphalangeal joint using costal cartilage grafts. J Hand Surg Br. 1992;17(5):583–585. https://doi.org/10.1016/s0266-7681(05)80248-7. Crossref, Google Scholar
5. Sato K, Sasaki T, Nakamura H, Toyama Y, Ikegami H. Clinical outcome and histologic findings of costal osteochondral grafts for cartilage defects in finger joints. J Hand Surg Am. 2008;33(4):511–515. https://doi.org/10.1016/j.jhsa.2008.01.003. Crossref, Google Scholar
6. Sato K, Iwamoto T, Matsumura N, Suzuki T, Nishikawa Y, Nakamura T. Total finger joint arthroplasty with a costal osteochondral autograft: up to 11 years of follow-up. J Hand Surg Eur Vol. 2019;44(2):167–174. https://doi.org/10.1177/1753193418806195. Crossref, Google Scholar
7. Chamay A. A distally based dorsal and triangular tendinous flap for direct access to the proximal interphalangeal joint. Ann Chir Main. 1988;7:179–183. https://doi.org/10.1016/s0753-9053(88)80061-9. Crossref, Google Scholar
8. Thomsen NO, Wikström SO, Müller G, Dahlin LB. Costal osteochondral graft for total metacarpal head replacement due to extensive osteochondral lesion. J Orthop Sci. 2014;19(6):1036–1039. https://doi.org/10.1007/s00776-013-0388-z. Crossref, Google Scholar
9. Satake Y, Nanno M, Kodera N, Takai S. Use of a costal osteochondral graft for reconstruction of a proximal phalanx head with a comminuted fracture of the proximal interphalangeal joint. J Nippon Med Sch. 2020;87(1):37–42. https://doi.org/10.1272/jnms.JNMS.2020_87-107. Crossref, Google Scholar
10. Leibovic SJ, Bowers WH. Anatomy of the proximal interphalangeal joint. Hand Clin. 1994;10:169–178. Crossref, Medline, Google Scholar