Volar plating versus external fixation for unstable dorsal fracture-dislocations of the proximal interphalangeal joint

摘要

We retrospectively compared the results of volar plating and dynamic external fixation for acute unstable dorsal fracture-dislocations of the proximal interphalangeal joint with a depressed fragment. We treated 31 patients (31 fingers), 12 with volar buttress plating and 19 with dynamic external fixation. Follow-up averaged 35 and 40 months in the two groups, with a minimal 6-month follow-up. Average active flexion of the proximal interphalangeal joint was 95 degrees after plate fixation and 87 degrees after external fixation, with an active extension lag of -6 degrees and -9 degrees, respectively. Active flexion at the distal interphalangeal joint averaged 67 degrees in the plate group and 58 degrees in the external fixation group, with active extension lags of 0 degrees and -5 degrees, respectively. We conclude that both methods can obtain a good range of motion at the proximal interphalangeal joint. A limitation of the extension of the distal interphalangeal joint occurred with dynamic external fixation but not with volar buttress plating.