A novel dynamic distraction external fixator for proximal interphalangeal joint fracture dislocation

Abstract

Objective To evaluate the efficacy of a novel dynamic distraction external fixator for proximal interphalangeal joint (PIPJ) fracture-dislocation. Methods From March 2005 to March 2014, 20 patients with PIPJ fracture-dislocation were treated with our technique. Function scores according to the Michigan Hand Outcome Questionnaire (MHQ) score, union time, grip strength, and range of motion (ROM) were recorded before and after treatment. Results All patients completed a mean follow-up of 22 months (range, 12–60 months). All patients achieved fracture union and joint reduction. The mean union time was 3 months (range, 2–6 months). The mean postoperative MHQ score was 88.00 ± 3.42 (range, 84.00–92.00). Postoperative grip strength of the affected sides was 92% of the contralateral sides. X-rays showed that the fracture line disappeared completely with a good joint contour. The range of extension in the PIPJ was −5° (range, −10°–0°). The range of flexion in the PIPJ was 89.40° ± 9.79° (range, 75°–100°). Postoperatively, four patients had slight narrowing of the joint space and two had an uneven articular surface. Pin breakage, loosening, and tract infection were not observed. Conclusions The novel dynamic distraction external fixator is a promising option for PIPJ fracture-dislocation.