Dynamic intradigital external fixation for proximal interphalangeal joint fracture dislocations

Treatment of Proximal Interphalangeal Dorsal Fracture-Dislocation Injuries With Dynamic External Fixation: A Pins and Rubber Band System

“…Many such devices use K-wires or pins without rubber bands, which do not allow for effective distraction across the PIP joint at all degrees of motion. 27,28,32,38 Agee et al 18 reported on one of the earliest pin and rubber band constructs in the literature. This device uses three pins.…”

“…2 wires, bands 86 3 7/16 Badia 38 2 wires 84 6 Not reported Deshmukh 23 2 wires, bands 84 5 1/14 remodeling Agee 18 3 wires, bands 83 3 (acute) 7 weeks (chronic) 3/9 arthritis (acute) 4/7 arthritis (chronic) De Smet 39 3 wires, bands 82 6 0/8 Gaul 27 2 wires 81 3 Not reported Suzuki 31 2-3 wires, bands 80 10 Not reported Hynes 28 2 wires 76 10 Not reported Syed 32 2 wires 71 6 1/9 arthritis 8/9 joint depression de Soras 33 3 wires, bands 84% opposite Not reported 3/11 remodeling ROM, range of motion (average total) in degrees or percent opposite side. Delay to surgery defined as time of injury to placement of external fixator (days).…”

Percutaneous Distraction Pinning for Metacarpophalangeal Joint Stabilization After Blast or Crush Injuries of the Hand

“…Other studies have shown results that vary from poor to excellent [1,4,12,13]. Omokawa et al [11] reported that 30 of their patients underwent removal of hardware and 20 patients required tenolysis.…”

“…The metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints are prone to pain and stiffness after injury [1,4,12,13]. Closed treatment and casting of these fractures often inadequately maintain proper alignment and impede wound care in cases of concomitant open wounds.…”

“…A distraction pinning technique represents a potential alternative, but results with this approach, to our knowledge, have not been reported. Questions/purposes The purposes of this study were (1) to evaluate the effectiveness (defined as osseous union and joint stability) of distraction pinning for comminuted fractures involving MCP joints after gunshot or crush injuries; (2) to report the short-term results in terms of pain and function in a small group of patients who underwent MCP distraction pinning; and (3) to evaluate complications and return to work status of these patients in the short term. Methods We reviewed 10 patients with comminuted pilon-type fractures of the base of the proximal phalanx or metacarpal head treated with wire distraction fixation from 2005 and 2014.…”