An Alternative Technique for External Fixation of Traumatic Intra-articular Fractures of Proximal and Middle Phalanx

Techniques in Hand & Upper Extremity Surgery
Benjamin KapurJohn Casaletto

Abstract

Intra-articular fractures of the proximal interphalangeal (PIP) joint are commonly treated with dynamic external fixation. Most commonly used is the Suzuki modification of the pins and rubber traction system (PRTS). There are a few other modifications of the PRTS external fixators. We present an alternative pin external fixator that is simple and effective. Under a suitable anesthesia and image intensification a true lateral view of the head of the proximal phalanx is obtained. A K-wire construct holds the affected digit out to length with the fracture reduced and Jurgan pin-balls hold the construct into position. Under image intensification the whole device is checked to ensure the joint and fracture is reduced and the joint is not over distracted. The PIP joint is also checked to ensure good range of motion. The device was checked in clinic at 1 week with radiographs. The wires are removed at 4 weeks followed by intensive hand physiotherapy. Over 20 patients with intra-articular fractures of the proximal and middle phalangeal were treated with this technique. In all cases the fracture healed with good joint congruency. All patients achieved good range of motion of the PIP joint but with some restriction of full flexion (mean,...Continue Reading

References

Sep 11, 1992·The Journal of Hand Surgery·D AshmeadJ B Jupiter
Jan 1, 1980·The Journal of Hand Surgery·W H BowersS Bittinger
Feb 1, 1994·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·Y SuzukiT Yokoi
Oct 23, 1997·The Journal of Bone and Joint Surgery. British Volume·N SenoY Morito
Sep 19, 2001·The Journal of Hand Surgery·K C Chung, S V Spilson

Citations

Oct 27, 2016·Hand Surgery and Rehabilitation·G PomaresGilles Dautel
Feb 11, 2020·Techniques in Hand & Upper Extremity Surgery·Omer YousafRyan D Katz

Related Concepts

Accidental Falls
Kirschner Wires
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External Fixation Devices
Fracture Healing
Recovery of Function
Phalanx of Hand
Volar Plate

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