Technical Note About Using Temporary Bridge Plate for Comminuted Interphalangeal Joint Fracture

摘要

Background: Dynamic external fixation has been mainly used for treatment of comminuted interphalangeal joint fracture; however, maintaining the fixation through this method has been difficult and uncomfortable. Based on the principle of ligament taxis, we introduce a novel method of inserting pre-bent metal hand mini-plate through minimal invasive technique for fixation and bony reunion of fragments resulted by intra-articular comminuted fracture. Patients and Methods: Fixation technique with pre-bent hand mini-plate was used in 7 cases of comminuted fracture of proximal interphalangeal joint (PIP) and 1 case of first carpo metacarpal (CMC) joint fracture. Temporary fixation was applied for 6 weeks, followed by plate removal and brisement manipulation and then passive continuous range of motion (ROM) exercise. The patients were followed up for a mean duration of 17 weeks, and simple radiographs recorded the degree of bony reunion and the ROM of interphalangeal joints measured with protractor. Results: An overall satisfactory result was achieved in all patients, with the mean ROM of 7 cases of PIP joint fracture being 2° of extension and 95.5° of flexion and that of 1 case of CMC fracture being 0° of extension and 58.5° of flexion. Furthermore, no serious complication was noted in any patient. Conclusion: Bridge plating method using ligament taxis may be a viable method in treating comminuted interphalangeal joint fracture.