Pins and Rubber Traction System for Intra-Articular Proximal Interphalangeal Joint Fractures Revisited

Abstract

The Pins and Rubber Traction System (PRTS) can be used to treat proximal interphalangeal intra-articular fractures. Our experience is that outcomes are not always excellent and that many patients have reduced joint function or residual deformities. The aim of this study was to evaluate the reasons behind the poorer outcomes of some of the patients treated with this system. A retrospective clinical and radiological evaluation was performed on 15 patients after a minimum of 2 years' follow-up. The mean interphalangeal joint flexion range was 66 degrees (range 0-100) in our series. The review of the literature shows an average active interphalangeal joint flexion of 78 degrees (range 64-95). Reasons for this difference include preoperative delay, technical deficiencies, the learning curve, a lack in postoperative physiotherapy and degenerative changes due to the longer follow-up. Although the Pins and Rubber Traction System seems a simple procedure, a learning curve is necessary to avoid pitfalls.

Treatment of proximal interphalangeal joint fractures by the pins and rubbers traction system: a follow-up

“…We found that the volar lip fractures were most frequent, which are in agreement with previously published papers [12,13]. Most fractures occurred during sports and men were more predominately injured (male:female ratio of 1.8) [5,12,[14][15][16]. The ring and little fingers were most often injured; probably since they are vulnerable as the outermost fingers and have extra mobility between the metacarpals [12,[15][16][17].…”

“…Radiological signs of posttraumatic osteoarthritis were found in 61%, where all three dorsal lip fractures showed signs of posttraumatic osteoarthritis. Arthrodesis or PIP joint prosthesis was rare, which is also the experience of other authors [6,13,16]. However, although 61% (25/41) showed radiological signs of osteoarthritis, the results from the subjective evaluation showed that most patients did not suffer from symptoms of osteoarthritis (i.e.…”

“…Most fractures occurred during sports and men were more predominately injured (male:female ratio of 1.8) [5,12,[14][15][16]. The ring and little fingers were most often injured; probably since they are vulnerable as the outermost fingers and have extra mobility between the metacarpals [12,[15][16][17]. Radiological signs of posttraumatic osteoarthritis were found in 61%, where all three dorsal lip fractures showed signs of posttraumatic osteoarthritis.…”

“…The most frequent reasons for early extraction were signs of infection or loose pins. The patients had seven (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) outpatient visits with a surgeon. The number of outpatient visits with a hand therapist was six (0-20).…”

Functional Outcomes Following Pilon Fractures of the Middle Phalanx Managed with the Ligamentotaxor External Fixator

“…15) Additionally the system allows more precise wire placement and more reproducible results. 16) Other recent studies on the Ligamentotaxor have reported similar results with average ROM at the PIPJ of up to 73°. 15) This is alongside improved grip strengths and DASH scores.…”