Biomechanical and functional analysis of the pins and rubbers tractions system for treatment of proximal interphalangeal joint fracture dislocations

Kneser, Ulrich; Goldberg, E.; Polykandriotis, Elias; Loos, Bernd; Unglaub, Frank; Bach, Alexander D.; Horch, Raymund E.

doi:10.1007/s00402-007-0526-1

Cited by 17 publications

(14 citation statements)

References 25 publications

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“…Even so, results in both these patients must be seen as failures of treatment. In the remaining 16 patients the final range of movement of the PIP joint was in the lower range of that reported by others who have published their results of Suzuki traction [2,4,6,[9][10][11].…”

Section: Discussionsupporting

confidence: 40%

“…This may be the result of our extensive use of thick vessel loops instead of rubber bands. It has been shown [10] that five to 10 times the usual force is required to flex a PIP joint in traction with rubber bands. It may be that even more force is required when thick vessel loops are used, which are much less elastic, and perhaps our patients were unable to overcome this resistance to flexion.…”

Section: Discussionmentioning

confidence: 99%

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Suzuki's pins and rubber traction for fractures of the base of the middle phalanx

Finsen

2010

Journal of Plastic Surgery and Hand Surgery

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Basal fractures of the middle phalanx are uncommon, but difficult to treat. We have reviewed our first 20 patients using the Suzuki pins and rubber traction who were treated during an 8.5 year period (June 1998-December 2006) and 18 who were reviewed after 49 (range 17-116) months. All injuries were closed fractures of the base of the middle phalanx. Ten patients had a fracture of the volar lip and dorsal subluxation of the phalanx, one had a fracture of the dorsal lip, and seven had comminuted pilon fractures. Median operating time was 33 (18-255) minutes. Thick "vessel loops" were often used for traction, and active movement before the traction was removed after 38 (8-46) days was disappointing. There were two superficial infections and one deep. One proximal interphalangeal (PIP) joint had been treated by arthrodesis and another amputated before review. On a visual analogue scale (VAS) from 0 (best) to 10 (worst), patients at review reported discomfort when wearing the traction as 5.5 (0-10), pain as 0 (0-6), and finger function as 3 (0-6). The median Quick-DASH score (100 = worst) was 2 (0-48) and grip strength 97 (75-118) % of the other hand. Median extension, flexion, and total range of movement of the PIP joint in 16 fingers were -9°, 83°, and 72°, respectively. Our results are no more than adequate. They might have been better if the force of traction had been less by using rubber bands instead of vessel loops, if postoperative follow-up had been more frequent allowing for correction of traction when necessary, and if traction had been discontinued earlier.

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Section: Discussionsupporting

confidence: 40%

Section: Discussionmentioning

confidence: 99%

Suzuki's pins and rubber traction for fractures of the base of the middle phalanx

Finsen

2010

Journal of Plastic Surgery and Hand Surgery

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“…Pin tract sepsis and osteolysis were never a problem, whereas such complications appear to be fairly frequent in other series [15,17,18] as evidenced by De Soras et al who reported five inflammations and one osteolysis out of a total of 11 cases [19]. This is probably due to the fact that in other series, the proximal pin was subjected to mechanical stress in rotation which is not the case in our series where the plastic spherical joints -and not the pins -absorbed the stress.…”

Section: Discussionmentioning

confidence: 94%

Treatment of complex proximal interphalangeal joint fractures using a new dynamic external fixator: 15 cases

Körting

Facca

Diaconu

et al. 2009

Chirurgie de la Main

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“…If we objectively analyse the quality of the frames, we can see that in eight cases of fracture of the middle phalanx, the traction pin was placed too proximally (Fig 1). It seems, however, that it could substantially increase the traction force of the flexor digitorum profundus tendon at 30 of flexion (Kneser et al, 2009). The issue here is not the force but the range of motion.…”

Section: Discussionmentioning

confidence: 95%

Pins and Rubber Traction System for Intra-Articular Proximal Interphalangeal Joint Fractures Revisited

Debus

Courvoisier

Wimsey

et al. 2010

J Hand Surg Eur Vol

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The Pins and Rubber Traction System (PRTS) can be used to treat proximal interphalangeal intra-articular fractures. Our experience is that outcomes are not always excellent and that many patients have reduced joint function or residual deformities. The aim of this study was to evaluate the reasons behind the poorer outcomes of some of the patients treated with this system. A retrospective clinical and radiological evaluation was performed on 15 patients after a minimum of 2 years' follow-up. The mean interphalangeal joint flexion range was 66 degrees (range 0-100) in our series. The review of the literature shows an average active interphalangeal joint flexion of 78 degrees (range 64-95). Reasons for this difference include preoperative delay, technical deficiencies, the learning curve, a lack in postoperative physiotherapy and degenerative changes due to the longer follow-up. Although the Pins and Rubber Traction System seems a simple procedure, a learning curve is necessary to avoid pitfalls.

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Biomechanical and functional analysis of the pins and rubbers tractions system for treatment of proximal interphalangeal joint fracture dislocations

Abstract: The PRTS allows for efficient treatment of intraarticular fractures with PiP involvement. Although standardized positioning of the wires is important, proximal position of the retraction only increased forces for 30 degrees flexion.

Cited by 17 publications

References 25 publications

Suzuki's pins and rubber traction for fractures of the base of the middle phalanx

Suzuki's pins and rubber traction for fractures of the base of the middle phalanx

Treatment of complex proximal interphalangeal joint fractures using a new dynamic external fixator: 15 cases

Pins and Rubber Traction System for Intra-Articular Proximal Interphalangeal Joint Fractures Revisited

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