Simplified Kirschner‑wire-based dynamic external fixator for unstable proximal interphalangeal joint fractures

Area of Science:

• Orthopedic surgery
• Hand surgery
• Traumatology

Background:

• Ligamentotaxis is a key treatment for complex articular fractures.
• Existing devices for proximal interphalangeal joint (PIPJ) fractures can be costly and complex.
• A need exists for simpler, more accessible treatment options.

Purpose of the Study:

• To evaluate the short-term functional and radiological outcomes of a simplified, preloaded Kirschner-wire (K-wire)-based dynamic external fixator.
• To assess the efficacy of this novel approach for complex intra-articular PIPJ fractures.

Main Methods:

• Prospective study of 20 consecutive patients with intra-articular PIPJ fractures.
• Radiographic assessment of fracture reduction, congruity, and healing.
• Functional evaluation using the Visual Analogue Scale (VAS), Michigan Hand Outcome Questionnaire (MHQ), PIPJ range of motion (ROM), and grip strength.

Main Results:

• All patients reported no residual pain at final follow-up.
• Average PIPJ ROM was 76.4°, average grip strength was 85% of the healthy side.
• Mean MHQ score was 83 points, with 88% of patients achieving excellent or good results.

Conclusions:

• The simplified K-wire dynamic external fixator is a simple, reliable, and cost-effective method for managing complex PIPJ fractures.
• The technique allows for early joint mobilization, leading to satisfactory functional outcomes.
• This approach offers a reproducible and time-saving alternative for PIPJ fracture management.