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Treatment of delayed proximal interphalangeal joint fractures with a handmade dynamic external fixator

Ali Gulec, Harun Kutahya, Recep Gani Goncu, Yunus Kirac, Mehmet Ali Acar.


Objectives: Although several methods are used in the treatment of intra-articular proximal interphalangeal (PIP) joint fractures, there is no universally accepted ideal method, and joint stiffness, deformity and degenerative osteoarthritis remain as significant complications. The aim of this study was to examine the results of patients treated with a handmade dynamic external fixator for PIP fractures delayed for at least 10 days and to investigate whether or not these patients had adequate finger movement.
Methods: A retrospective study was conducted in patients treated with a handmade dynamic external fixator for PIP joint fractures in the Orthopaedic Department at the Selçuk University Medical Faculty Hospital. The results of 12 cases were examined in which treatment had been neglected for various reasons, with at least 10 days passing since the injury occurred.
Results: The cases included 1 female and 11 males with a mean age of 25.9 years. The mean time from injury to operation was 12.1 days. The device was left in the finger for a mean of 32.9 days. At the final follow-up examination, 7 patients had full ROM, while 4 patients had full extension, but flexion was restricted, ranging from 5° to 15°, and in 1 case both extension and flexion restriction were 15°. The mean follow-up period was 13.7 months, during which no patient reported any pain, nor were there any findings of osteomyelitis, as determined radiologically or clinically.
Conclusion: Treatment with an external fixator is a method that is quick, inexpensive and easy to apply. Fixation using a handmade dynamic external fixator for the treatment of PIP fractures is safe and technically simple. Additional extensive studies are required on this subject.

Key words: Dynamic external fixator, proximal interphalangeal joint fractures, k-wire

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