Single-Stage Distraction Correction for Neglected Dorsal Fracture Dislocations of the Proximal Interphalangeal Joint: A Report of Eight Cases

Abstract

We present the outcome of treatment of eight chronic neglected dorsal fracture dislocations of the proximal interphalangeal joint treated with a single-stage ligamentous distraction using the Penning mini-external fixator and a closed reduction. The distraction correction and 2 to 3 mm over distraction was performed acutely at the time of operation in all eight cases at an average injury-to-surgery time of 6 weeks. Satisfactory results with an average range of motion of 79 degrees were obtained at an average follow-up of 20 months. This technique is simple, effective and offers the advantage of being minimally invasive. We recommend this single-stage distraction correction technique for the treatment of chronic neglected dorsal dislocations of the proximal interphalangeal joint, which are no more than 10 weeks-old.

A new technique for closed management of displaced intra-articular fractures of metacarpal and phalangeal head delayed on presentation: report of eight cases

“…The Pennig mini-external fixator is a simple and secure device that allows controlled, gradual joint distraction and closed fracture reduction by capsuloligamentotaxis. It has previously been described in the successful treatment of hand fractures, including a series of neglected dorsal fracture dislocations of the proximal interphalangeal joint (Houshian et al, 2008; Pennig et al, 2000).…”

Ergebnisse der Rekonstruktion der Mittelgliedbasis am Finger durch ein osteochondrales Transplantat vom Os hamatum

“…Es ist auch der Mittelgelenksprothese überlegen, weil es bei gleichwertigem Bewegungsumfang die Komplikationen der Endoprothese umgeht und das rekonstruierte Gelenk belastbarer und in seiner Haltbarkeit nicht limitiert ist [23]. Versuche, die Beweglichkeit durch externe Distraktion wiederherzustellen, führen zu ähnlichen funktionellen Ergebnissen [24], werden aber nur für einen Zeitraum von bis zu 10 Wochen nach dem Unfallereignis empfohlen [25].…”