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We present a rare case of a lateral dislocation of the proximal interphalangeal joint that required open reduction. During an operation, we found the collateral ligament and the capsule interposing into the joint space. After reducing the soft tissue and reproducing the collateral ligament with a suture anchor, sufficient joint stability and full range of motion was achieved.

Volar dislocations of the proximal interphalangeal joint, if missed, with extensor tendon entrapment will lead to permanent impairment. Prompt diagnosis followed by open reduction and aggressive rehabilitation is necessary.

Chronic lunate dislocation is a difficult problem to deal with. We describe a surgical technique whereby gradual wrist distraction is applied using an external fixator followed by open repositioning of the lunate. We have successfully used this technique in a rugby player with an undiagnosed chronic lunate dislocation. Our case was able to return to competitive rugby playing.

To clarify the factors affecting functional results of fracture-dislocations of the proximal interphalangeal (PIP) joint treated by open reduction and internal fixation (ORIF), 60 patients, including 38 patients with a dorsal fracture-dislocation and 22 with a pilon fracture, were analysed. The mean ratio of articular surface involvement was 48.5% and a depressed central fragment existed in 75.3% of the cases. ORIF was performed in 47 patients through a lateral approach using Kirschner wires and in 13 through a palmar approach using a plate or screws. The mean flexion, extension and range of motion (ROM) of the PIP joint was 89.5°, 11.5° and 78.0°, respectively. Stepwise regression analysis revealed that a delayed start of active motion exercise after surgery, elderly age and ulnar ray digit were factors affecting functional outcomes. Although ORIF allows accurate restoration of the articular surfaces, an early start of motion exercise is essential for good results.

Introduction: Developmental dysplasia of the hip (DDH) has a wide spectrum of conditions and treatment plans. Our aim in this study is to investigate related and controllable factors that can lead to secondary redislocation, and use them to foresee a concomitant pelvic osteotomy requirement.

Methods: This is a retrospective case-control study on DDH cases reduced via an anterior approach without pelvic osteotomy in our orthopedics hospital from 2019 to 2021. After 24 months, we compared clinical and radiological findings between the failure and successful groups.

Results: We reduced 49 hips (38 cases) using an anterior approach without osteotomy. The success rate was 89.8% (five cases re-dislocated), which is accountable for favorable odds. We found no statistically significant correlation between re-dislocation and bilaterality ($p$ = 0.64), gender ($p$ = 0.27) or age ($p$ = 0.82), or the AI before reduction ($p$ = 0.19).

Conclusion: When the reduction has a wide safe zone in the operating room, the reduction of the hip without osteotomy can have satisfactory results, so based on the findings of our study, invasive procedures such as osteotomy will not be necessary if the hip is stable after the open reduction in the operating room.

Background: Dorsal rotation or persistent displacement of the fracture fragment is frequently encountered in extension block pinning for mallet fractures. We reviewed nine irreducible mallet fracture patients treated with mini-open reduction and extension block pinning.

Methods: A small V-shaped incision was made on the fracture gap when there was persistent displacement of fracture fragment despite closed maneuvers and percutaneous procedures while performing extension block pinning. Soft tissue or granulation tissue hampering reduction was removed through the incision. Anatomical reduction was guided with a freer elevator. The incision was closed by distal interphalangeal joint transfixation in extension without any suture. Pin tips were buried under the skin. The incision and pin entry sites were covered with skin adhesive, and the patients were allowed to wash their hands 1–2 days after the surgery. No splint was applied postoperatively. Mean follow-up period was 13 months.

Results: Anatomical reduction was achieved in 7 out of 9 patients. In the rest 2 patients, postoperative step-off of the articular surface at the fracture site was less than 0.5 mm. Solid union was achieved in all cases. The mean extension lag at final follow-up was 0°. No patient developed postoperative external bleeding or other complications in the incision site or the pin site.

Conclusions: Mini-open reduction and extension block pinning appears to be a good option for irreducible mallet fractures, which improves reduction quality and patients’ convenience.

Background: Open reduction and internal fixation with a plate is one of the alternative treatments for fracture–dislocation of the proximal interphalangeal (PIP) joint. However, it does not always lead to satisfactory results. The aim of this cohort study is to describe the surgical procedure and discuss the factors affecting the treatment results.

Methods: We retrospectively reviewed 37 cases of consecutive unstable dorsal fracture–dislocation of the PIP joint treated using a mini-plate. The volar fragments were sandwiched with a plate and dorsal cortex, and screws were used as subchondral support. The average rate of articular involvement was 55.5%. Five patients had concomitant injuries. The mean age of the patients was 40.6 years. Mean time between injury and operation was 11.1 days. The average postoperative follow-up duration was 11 months. Active ranges of motion, % total active motion (TAM) were evaluated postoperatively. The patients were divided into two groups according from Strickland score and Gaine score. Fisher’s exact test, Mann–Whitney U test and a logistic regression analysis were used to evaluate the factors affecting the results.

Results: The average active flexion, flexion contracture at the PIP joint, and % TAM were 86.3°, 10.5° and 80.6%, respectively. Group I included 24 patients who had both excellent and good scores. Group II included 13 patients who had neither excellent nor good scores. When the groups were compared, there was no significant relationship between the type of fracture–dislocation and the extent of articular involvement. There were significant associations between outcomes and patient age, period from injury to surgical intervention and presence of concomitant injuries.

Conclusions: We concluded that meticulous surgical technique leads to satisfactory results. However, factors, including the patient’s age, time from injury to surgery and the presence of concomitant injuries needing adjacent joint immobilisation, contribute to unsatisfactory outcomes.

Level of Evidence: Level IV (Therapeutic)