Treatment of comminuted intra-articular proximal interphalangeal joint fracture using static external fixation with or without supplementary Kirschner wires

摘要

Background: The proximal interphalangeal joint plays a crucial role in the function of the hand. It has been referred to as the anatomical and functional locus of finger function. Its injuries can cause significant loss of hand function and consequent disability. In this study, the functional and radiological results of the management of this fracture using a static external fixator with or without supplementary k wire fixation will be evaluated Patients and methods: From June 2010 to July 2012, there were 19 patients whom suffered from closed comminuted intra-articular proximal interphalangeal fracture injuries. The age of the patients at the time of injury ranged from 20 to 35 years, with a mean of 27 years. All the included patients had closed fractures with displaced articular cartilage surfaces and were treated using a static external fixator with or without supplementary k wire fixation.Results: The mean follow up period was 18 months with a range from 12 to 24 months. The duration of bone healing till solid union ranged from 4 to 7 weeks, with a mean of 5 weeks. The mean ROM for the PIP at the follow- up evaluation was from 14.5° (range 5° to 25°) to 89.7° of flexion (range 80° to 95°). The mean visual analog pain scale averaged 1.95 ± 0.7. The mean TAM score for all treated fingers was 86.6 ± 5 (range 80–95). At final evaluation, no instability of the PIP was noted and all the cases showed satisfactory clinical and functional results of the affected finger.Conclusions: Based on the clinical and radiological outcomes of this study at the final follow-up examination, it was found that the use of the static external fixator in the treatment of comminuted intra-articular proximal interphalangeal fracture is an adequate technique.