Proximal interphalangeal joint fractures of the hand: treatment with an external dynamic traction device

The authors present a series of 11 consecutive patients who sustained an intra-articular fracture of the proximal interphalangeal (PIP) joint and 1 patient with a fracture of the interphalangeal joint of the thumb treated with a Kirschner wire external dynamic traction device. Range of motion and grip strength were measured. We used the Michigan Hand Outcome Questionnaire (MHQ) to obtain a subjective response to the treatment. Average range of motion of the PIP joint was 64 degrees and distal interphalangeal joint was 52 degrees . The average grip strength was 86% with a mean MHQ score of 90. Two patients had pin site infections treated successfully with antibiotics. All fractures had united at final follow up with <1-mm articular step present. Our series highlights that these are difficult injuries to treat and that anatomic reduction is not always possible. However, this technique is simple and quick to perform while allowing early joint mobilization. The subjective response to treatment is comparable with other studies using a similar device.