Dynamic digital traction for unstable comminuted intra-articular fracture-dislocations of the proximal interphalangeal joint

The S-Quattro in the Management of Acute Intraarticular Phalangeal Fractures of the Hand

“…Several techniques of distraction have been described with variable results. These include external fixation devices (Allison, 1996;Hynes and Giddins, 2001) using a force couple splint (Agee, 1987;Buchanan, 1994), dynamic longitudinal traction (Dennys et al, 1992;Morgan et al, 1995;Schenck, 1986), compass hinges (Bain et al, 1998;Krakauer and Stern, 1996), pins and rubber traction systems (DeSoras et al, 1997;Majumder et al, 2003;Suzuki et al, 1994) and dynamic springs (Blazar and Steinberg, 2000;Inanami et al, 1993;Johnson et al, 2004). All existing techniques have their advantages and disadvantages.…”

Dynamic intradigital external fixation for proximal interphalangeal joint fracture dislocations

“…6,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Early motion of the PIP joint along with traction and stable fixation have provided the best functional results. 18,21,27,29 Gaul and Rosenberg 29 described a simple frame that provided traction without using rubber bands or complicated connecting pieces.…”

Dynamic traction and minimal internal fixation for thumb and digital pilon fractures

“…Previous researchers have reported asymptomatic joint incongruity with this method. 10,11 This approach has been adequate for reducing the dorsal and volar fragments because they are attached to the surrounding soft tissues; however, the central articular depression cannot be adequately elevated with this method alone. In addition, pilon fractures associated with large displaced fragments may be at times inadequately treated with ligamentotaxis alone, which prompted us to consider limited internal fixation in addition to dynamic traction.…”

“…In this small series, the final arc of motion was consistent with previous reports of dynamic traction. 10,11,14 The major advantage of supplemental internal fixation is the ability to remove the traction device at an earlier time. In our series, the traction apparatus was removed at 3.5 weeks after surgery without major complications.…”

“…1,10 -12 Most advocate traction and indirect reduction via ligamentotaxis, and they report adequate remodeling of the joint surface. 10,12 Most articles advise caution toward any form of open reduction because of the accompanying comminution and possible complications. 14 To our knowledge, no article reports on treatment for pilon fractures of the thumb metacarpophalangeal (MCP) joint.…”