An Adjustable Kirchner Wire Frame Traction Method for the Treatment of Dorsal Fracture-Dislocation of the Distal Interphalangeal Joint

Abstract

We applied an adjustable traction method which enables early range of motion exercise for the dorsal fracture-dislocation of the distal interphalangeal joint, and obtained satisfactory results. The reduction of comminuted fragments or depression of the joint is unnecessary using the traction method, because early exercise accelerates the remodelling of the injured soft tissue, followed by the development of joint stability. This traction mechanism is independent of the vector force of the traction applied due to the frame-structure construction. Our method makes it easy to adjust the traction force in millimetre increments of the glove-finger length, and has broad range of traction force. In cases where the dislocation is persistent even after strengthening the traction force, a transverse-transfixing Kirschner wire (K-wire) can be inserted to hold the reduction securely against subluxation.

Results of an Adjustable Traction Method Using Surgical Gloves and K-Wires for the Treatment of Proximal Interphalangeal Joint Fracture Dislocation

“…The surgical procedure was the same as that described in the by Kuroshima 9 and similar to that reported by Kobayashi. 11 K-wires (1.0 mm in diameter) were inserted at the center of the proximal phalangeal head and the distal part of the middle phalanx to create a frame ( Fig. 2 A).…”

“…Kobayashi has applied this method to two patients with dorsal fracture dislocation of the distal interphalangeal joint; 11 they initiated early ROM exercises and obtained satisfactory results. Although these are not dynamic devices, Kimura et al 12 modified this method and applied it to fractures of the distal radius, distal ulna, and diaphyses of the radius and ulna.…”