Dynamic External Fixation for Complex Intraarticular Phalangeal Fractures

Abstract

Intraarticular phalangeal fractures are difficult to treat. The advantages of using dynamic external fixation devices include distraction of impacted fracture fragments and reduction in joint stiffness by allowing early joint mobilization. Previous reports have concentrated on pilon fractures and dorsal fracture dislocations affecting the proximal interphalangeal joint. We report our experience using a dynamic external spring fixator in the management of 15 patients with a variety of fracture patterns affecting the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints. In three cases the device spanned two adjacent joints. Long-term follow-up has shown excellent range of joint movement and no major complications. We consider that this device is an effective tool in the management of a range on complex intraarticular phalangeal fractures.

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

“…Interphalangeal joint fractures are generally held to be serious lesions and there is no doubt that early and effective reduction offers the best hope for a reasonably satisfactory outcome [3,[8][9][10][11][12]. Any type of treatment should therefore aim to combat oedema, prevent tendinous adhesions and joint stiffness and facilitate rehabilitation via a mobilization at the earliest opportunity [5,13].…”

Prospective Outcomes of Comminuted Periarticular Metacarpal and Phalangeal Fractures Treated Using a Titanium Plate System

“…[17][18][19] Comminuted metacarpal and phalangeal fractures of the hand are challenging to manage, which in itself may account for the high incidence of unsatisfactory results. 20,21 Various techniques have been described for their treatment: Kwire fixation, 22 tension band wiring, 23,24 external fixation, [25][26][27] and internal fixation with plates and screws. 13,28 -31 In recent years, a number of titanium plate systems for small bones of the hand have been introduced.…”

Treatment of Proximal Interphalangeal Dorsal Fracture-Dislocation Injuries With Dynamic External Fixation: A Pins and Rubber Band System

“…Forces can then be applied through the pins and across the joint with rubber bands 23,24,31,33 or springs and pulleys. 25,29,34,35 All dynamic external fixators share fundamental properties. First, they provide distraction across the PIP joint, which takes load off the articular cartilage, thereby allowing it to heal without a displacement force.…”