A scoping review of applications and outcomes of traction orthoses and constructs for the management of intra-articular fractures and fracture dislocations in the hand

Packham, Tara; Ball, P; MacDermid, Joy C.; Bain, James R.; DalCin, Arianna

doi:10.1016/j.jht.2016.04.001

Cited by 10 publications

(11 citation statements)

References 104 publications

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“…Intra-articular fractures are challenging cases for hand surgeons and anatomic reduction is necessary for a good outcome with respect to movement and function. In these cases, external fixation systems may give a good outcome with minimal tissue trauma [9].…”

Section: Discussionmentioning

confidence: 99%

A Bridging: Distraction External Fixation for a Severely Comminuted Fracture of the Middle Phalanx. A Case Report

Galanopoulos

Vynichakis

2019

Cureus

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Severely comminuted fractures of the middle phalanx of the digits are known to be demanding cases for hand surgeons. The restoration of the length and axis of the phalanx, such as the anatomic reduction of the articular surface in case of intra-articular association are basic principles that have to be followed. A simple and cheap device consisting of two Kirschner wires and a nylon suture can work as an external fixation system based on the principle of ligamentotaxis. As a result, the anatomic reduction of the fracture with minimal soft tissue damage and simple surgical equipment is feasible.

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Section: Discussionmentioning

confidence: 99%

A Bridging: Distraction External Fixation for a Severely Comminuted Fracture of the Middle Phalanx. A Case Report

Galanopoulos

Vynichakis

2019

Cureus

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“…There is similarity between surgeons and therapists in reporting traction orthoses as the least common reason for referral, whilst referral for treatment of contracture of the PIP joint shows fewer surgeons (n = 2) reporting this compared to therapist responses (n = 9). Extensor lag/PIP joint contracture is widely reported in outcomes for many methods of PIP joint fracture management and therefore is expected to commonly form part of therapy management (Aladin and Davis, 2005;Packham et al, 2016;Ikeda et al, 2011;Watanabe et al, 2015). Referral to therapy within seven days of injury is reported more consistently in this study by plastic surgeons than by orthopaedic surgeons.…”

Section: Referral To Therapymentioning

confidence: 99%

An investigation of the acute management of closed intra-articular fractures of the proximal interphalangeal joint in Ireland

Harmon¹,

Spirtos

2020

IJOT

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Purpose Many treatment methods for intra-articular fractures of the proximal interphalangeal (PIP) joint are described in the literature without a consensus on the most effective approach. The purpose of this study was to investigate the methods of treatment of PIP joint fractures being used by trauma surgeons in the Republic of Ireland currently and the timing of referral to therapy. Design/methodology/approach A cross-sectional descriptive study methodology was used to survey trauma surgeons, occupational therapists and physiotherapists in Ireland. An online platform was used. A total of 21 surveys were returned by surgeons and 37 by therapists. Descriptive statistical analysis was used to present the results. Findings Buddy strapping was reported as the primary treatment method for stable PIP joint fractures. All levels of fracture severity were reported to be treated using traction constructs, which include static and dynamic fixation and orthoses. Unstable fractures were managed using open reduction with internal fixation by 50 per cent of surgeons. Early timing of referral to therapy is reported by more surgeons than therapists. The majority of therapists indicated that they did not have the resources to see patients at the optimal time. Originality/value To the authors’ knowledge, this study provides the first description of the management of PIP joint fractures across the Irish health service. The findings of this study suggest that additional therapy resources are required within the health service executive to facilitate the desired early referral to therapy and to enable service development for this category of hand fractures.

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“…Various other dynamic skeletal systems have been presented in the literature [ 17 – 20 ]. Packham et al [ 21 ] conducted a scoping review that comprehensively examines the applications and outcomes of these systems as well as other traction orthoses and constructs. With skeletal systems, the distraction force exerted between the hook and counter traction pins remains constant as the base for distraction is fixed, whereas any slippage or movement that occurs in orthotic based systems will result in an alteration to the distraction force [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Distraction ligamentotaxis for complex proximal interphalangeal joint fracture dislocations: a clinical study and the modified pins rubber band traction system revisited

Nothdurft

Park

et al. 2018

Burns &Amp; Trauma

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BackgroundThe purpose of this study is to present our experience with the modified pins and rubber band traction system, discuss problems encountered, and make recommendations to optimize outcomes.MethodsData was collected prospectively from November 2013 to March 2017 at a tertiary referral hospital in Melbourne, Australia. Patients with closed complex proximal interphalangeal joint fracture dislocations that were considered unsuitable for other surgical options were included in the study. Patients underwent dynamic skeletal distraction using the modified (Deshmukh) pins rubber band traction system. Outcomes were measured using the Nominal Rating Scale for pain; Disabilities of the Arm, Shoulder, and Hand (DASH) score; active and passive range of motion; patient rating scale; and complications.ResultsTwenty patients underwent the procedure, and 19 were included in analyses. At the final follow-up assessment, an average of 62° and 77° was achieved for proximal interphalangeal joint active and passive range of motion, respectively. Pain levels were low (median score of 0 at rest and 1 ranging, out of 10). Four patients suffered minor pin site infections.ConclusionDistraction ligamentotaxis is a useful part of the armamentarium, especially in the absence of more suitable procedures. It is important to select appropriate patients, educate, and ensure adherence to postoperative therapy. Employing the Deshmukh frame modification streamlines the theatre processes, and removal of wires at approximately 4 weeks minimizes risk of pin site infection.

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A scoping review of applications and outcomes of traction orthoses and constructs for the management of intra-articular fractures and fracture dislocations in the hand

Cited by 10 publications

References 104 publications

A Bridging: Distraction External Fixation for a Severely Comminuted Fracture of the Middle Phalanx. A Case Report

A Bridging: Distraction External Fixation for a Severely Comminuted Fracture of the Middle Phalanx. A Case Report

An investigation of the acute management of closed intra-articular fractures of the proximal interphalangeal joint in Ireland

Distraction ligamentotaxis for complex proximal interphalangeal joint fracture dislocations: a clinical study and the modified pins rubber band traction system revisited

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