[Proximal interphalangeal joint replacement: A comparison between the volar and dorsal approach]. / Artroplastia de la articulación interfalángica proximal: comparación entre el abordaje palmar y dorsal.

INTRODUCTION: Arthropathy of the proximal interphalangeal (PIP) joint symptoms is very restrictive, and in some cases arthroplasty is required. In most of the reported series of PIP silicone arthroplasty, the technique described is the dorsal approach. As far as we know, the role of the volar approach in PIP arthroplasty has still not been adequately assessed. OBJECTIVES: To retrospectively review the patients who had PIP joint arthroplasty, and to study the clinical and radiographic outcomes in relation to the approach: volar or dorsal. METHODS: A total of 22 PIP joint replacements were performed between 2005 and 2010. The mean age was 56 years and the mean follow-up period was 29 months. The implant used in all patients was the Avanta® PIP Soft-Skeletal Implant (Avanta Orthopaedics, San Diego, USA). The dorsal approach was performed in 14 joints, and a volar approach in 8 joints. The preoperative clinical evaluation included a visual analogue scale (VAS) and the range of motion (ROM). The preoperative ROM mean was -15°/60° in both groups. The VAS and the ROM in the last follow-up visit were recorded and compared with preoperative values. RESULTS: The postoperative ROM of the dorsal approach group had a mean of -15°/60°, and that of the volar approach was -2°/62°. CONCLUSION: It was found that the volar approach in this series offers the advantages of maintaining the integrity of the extensor mechanism, resulting in a complete restoration of the extension in the range of motion.

[Fenton syndrome]. / Síndrome de Fenton.

Scaphocapitate, or Fenton syndrome, is a rare injury. This article presents three new cases that were treated by open reduction and internal fixation with miniscrews, obtaining good results at 16 months follow-up.

Artroplastia de la articulación interfalángica proximal: comparación entre el abordaje palmar y dorsal / Proximal interphalangeal joint replacement: a comparison between the volar and dorsal approach

Introducción. La artropatía de las articulaciones interfalángicas proximales (AIP) cursa con síntomas muy restrictivos, siendo algunos casos tributarios de artroplastia. En la mayoría de las series de artroplastias de las AIP la técnica utilizada es a través de un abordaje dorsal. El papel del abordaje palmar en la artroplastia de las AIP todavía no se ha valorado suficientemente. Objetivo. Revisar retrospectivamente los pacientes intervenidos de artroplastia de la AIP, y determinar si las realizadas por vía palmar consiguen un rango de extensión mayor que las realizadas por vía dorsal. Pacientes y métodos. Entre 2005-2010 se realizaron 22 artroplastias de AIP. La media de seguimiento fue de 29 meses. El implante que se utilizó en todos los pacientes fue el implante de silicona de AIP modelo Avanta® (Avanta Orthopaedics, San Diego, California, EE. UU.). Se realizó un abordaje dorsal en 14 articulaciones y un abordaje palmar en 8. La valoración clínica preoperatoria incluyó la escala visual analógica (EVA) y el arco de movimiento. El arco de movimiento preoperatorio medio era de -15°/60° en ambos grupos. En la última visita del seguimiento, la EVA y el rango de movimiento se registraron y se compararon con los valores preoperatorios. Resultados. El arco medio de flexo-extensión postoperatorio del grupo del abordaje dorsal era de -15°/60°, y el del abordaje palmar de -2°/62°. Conclusión. En nuestra serie hemos observado que las artroplastias de AIP realizadas por vía palmar consiguen un rango de extensión mayor que aquellas realizadas por vía dorsal. El abordaje palmar ofrece las ventajas de mantener la integridad del mecanismo extensor (AU)

Introduction. Arthropathy of the proximal interphalangeal (PIP) joint symptoms is very restrictive, and in some cases arthroplasty is required. In most of the reported series of PIP silicone arthroplasty, the technique described is the dorsal approach. As far as we know, the role of the volar approach in PIP arthroplasty has still not been adequately assessed. Objectives. To retrospectively review the patients who had PIP joint arthroplasty, and to study the clinical and radiographic outcomes in relation to the approach: volar or dorsal. Methods. A total of 22 PIP joint replacements were performed between 2005 and 2010. The mean age was 56 years and the mean follow-up period was 29 months. The implant used in all patients was the Avanta® PIP Soft-Skeletal Implant (Avanta Orthopaedics, San Diego, USA). The dorsal approach was performed in 14 joints, and a volar approach in 8 joints. The preoperative clinical evaluation included a visual analogue scale (VAS) and the range of motion (ROM). The preoperative ROM mean was -15°/60° in both groups. The VAS and the ROM in the last follow-up visit were recorded and compared with preoperative values. Results. The postoperative ROM of the dorsal approach group had a mean of -15°/60°, and that of the volar approach was -2°/62°. Conclusion. It was found that the volar approach in this series offers the advantages of maintaining the integrity of the extensor mechanism, resulting in a complete restoration of the extension in the range of motion (AU)

Síndrome de Fenton / Fenton syndrome

El síndrome de la fractura-luxación transescafo-hueso grande o síndrome de Fenton, constituye una lesión muy poco frecuente. En este artículo se presentan 3 casos que fueron tratados mediante reducción abierta y fijación interna con minitornillos, obteniendo buenos resultados a los 16 meses del seguimiento medio (AU)

Scaphocapitate, or Fenton syndrome, is a rare injury. This article presents three new cases that were treated by open reduction and internal fixation with miniscrews, obtaining good results at 16 months follow-up (AU)