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J Hand Microsurg
DOI: 10.1055/s-0042-1751275
Original Article

Hand-Specific External Fixation for Treatment of Complex Proximal Interphalangeal Joint Injuries

Naji S. Madi 
1   Department of Orthopaedic Surgery, Rutgers University, Newark, New Jersey, United States
,
Clay B. Townsend 
2   Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Richard McEntee
2   Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Alexander Marcus
3   Orthopedic Associates of Central Jersey, Edison, New Jersey, United States
,
Virak Tan 
4   Institute for Hand and Arm Surgery, Harrison, New Jersey, United States
,
Pedro Beredjiklian
2   Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
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Abstract

Background Complex proximal interphalangeal joint (PIPJ) fractures are challenging injuries to treat. There are multiple established treatment methods available for these injuries, including dynamic external fixation. This study reports the outcomes of complex PIPJ fractures treated with a hand-specific external fixation device.

Methods Twenty-five fingers in 25 patients were treated with the DigiFix external fixator device for treatment of a PIPJ dorsal fracture dislocation (n = 16) or pilon fracture (n = 9). There were 16 males and 9 females with a mean age of 40 years (range: 14–75 years) at the time of injury. The median time from injury to surgery was 10 days (interquartile range [IQR]: 5; range: 3–49). Chart and radiographic data were reviewed retrospectively.

Results The average duration of external fixation was 41 days (range: 26–62 days). At a mean follow-up of 28 weeks (range: 12–105 weeks), the mean PIPJ flexion was 82 (range: 30–105 degrees), extension was −10° (range: −30 to 0 degrees), and flexion/extension arc of motion was 72 degrees (range: 30–95 degrees). Final mean Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score was 21.5 (range: 0–65.8). There were zero major complications and six (24%) minor complications, including superficial cellulitis (4) and stiffness (2).

Conclusion Dynamic external fixation for the treatment of complex PIPJ injuries allows for early range of motion and leads to favorable outcomes. This hand-specific external fixator has a reproducible technique which results in predictable and reliable PIPJ distraction.

Keywords

dynamic external fixation - hand trauma - phalanx fracture - proximal interphalangeal joint dislocation - proximal interphalangeal joint fracture


Publication History

Article published online:
27 August 2022

© 2022. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.

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