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Distraction for proximal interphalangeal joint contractures: long-term results.

Shirzad Houshian1, Shan Shan Jing, Gholam Hussein Kazemian

  • 1Department of Orthopaedic Surgery, Braintree Community Hospital, Mid Essex, United Kingdom; The Department of Plastic Surgery, Broomfield Hospital, Chelmsford, Mid Essex, United Kingdom; Department of Orthopaedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran.

The Journal of Hand Surgery
|September 12, 2013
PubMed
Summary

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Joint distraction with external fixators effectively treats chronic post-traumatic proximal interphalangeal (PIP) joint contractures, improving range of motion with good long-term outcomes. Careful patient selection is key for successful treatment.

Area of Science:

  • Orthopedic surgery
  • Traumatology
  • Rehabilitation medicine

Background:

  • Chronic post-traumatic proximal interphalangeal (PIP) joint contractures limit hand function.
  • Previous treatments for these contractures have shown variable success.

Purpose of the Study:

  • To evaluate the medium- to long-term efficacy of joint distraction using a unilateral external fixator for chronic traumatic PIP joint contractures.

Main Methods:

  • Ninety-eight PIP joints in 94 patients with chronic flexion deformities were treated with external fixation.
  • The average duration of joint distraction was 10 days, with a mean follow-up of 54 months.

Main Results:

  • Significant improvements were observed in both active range of motion (average 67°) and joint extension (average 40°).
Keywords:
ContracturePIP jointdistractionlong-term

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  • No loss of motion occurred at the latest follow-up; younger patients showed slightly better outcomes.
  • Minor complications included transient swelling and superficial pin-site infections, managed conservatively.

    • Conclusions:

    • Unilateral external fixation is a safe and effective treatment for chronic traumatic PIP joint contractures.
    • Predictable medium- to long-term functional improvements can be achieved.
    • Careful patient selection and monitoring are essential for optimal results.