An Alternative Technique for External Fixation of Traumatic Intra-articular Fractures of Proximal and Middle Phalanx

Abstract

The main advantages of the technique we describe are: (1) the compact design, making it less cumbersome for the patient compared with other PRTS external fixators; (2) it is straightforward to assemble and the device is easy to adjust in clinic if there is any loss of reduction; (3) the pin-balls prevent sharp ends of the wire protruding causing morbidity to the patient; (4) there is less chance of loss of traction compared with traction devices using rubber bands. It is a dynamic device, which allows mobilization of the joints reducing stiffness.

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“…This system is capable of treating a wide range of complex intra-articular fractures involving the hand, including PIP fractures, metacarpophalangeal joint (MCPJ), and first carpometacarpal joint (CMCJ), with good ROM results at final follow up [5][6][7]. Some variations or this system were described [2][3][4][5][6][7][8], using more available materials but nevertheless following the same principles. Our external fixator is more similar to the one described by Crowley et al [9], that presented a case of a contaminated fracture associated to an FDP avulsion, which presented a ROM of the PIP joint of 15-95° at final follow-up of one year.…”

Use of a Multivector Mandibular Distractor for Treatment of Pediatric Proximal Interphalangeal Joint Pilon Fractures: A Case-Based Review

“…13 Multiple other modifications to and variations on these protocols also exist. 4,11,14,16,19,21,22 The variety in treatment approaches is not surprising given how fracture patterns differ depending on the mechanism, direction, and force of injury. 1 Ultimately, however, some variation of dynamic trac tion is arguably the most accepted therapeutic method for pilon fractures given ligamentotaxis can be achieved while allowing for early motion of the joint.…”

“…Here the authors present a case report detailing a unique approach to treatment of a pilon fracture of the middle phalanx using open reduction and multivector external fixa tion in a pediatric patient. 16…”

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

“…They may include not only fractures but also open wounds with various degree of soft tissue damage. The combination of a comminuted, open fracture of the middle phalanx with severe soft tissue damage limits the treatment options and any procedure should be carefully planned [1]. An external fixation system based on the principle of ligamentotaxis can give a good outcome, with minimal additional tissue trauma [2].…”