Unstable Middle Phalanx Base Fractures Treated With an Internal Joint Stabilizer: Preliminary Results

Area of Science:

• Orthopedic surgery
• Hand surgery
• Traumatology

Background:

• Unstable fractures of the middle phalanx base often lead to chronic proximal interphalangeal (PIP) joint dysfunction.
• These injuries present a significant challenge for hand surgeons.
• A temporary, intraoperatively constructed internal joint stabilizer was developed for unstable PIP joint injuries.

Purpose of the Study:

• To evaluate the efficacy of a temporary internal joint stabilizer for acute unstable pilon fractures or fracture-dislocations of the middle phalanx base.
• To assess functional outcomes, including range of motion and complication rates.

Main Methods:

• A retrospective chart review was conducted across two institutions.
• Included patients had acute middle phalanx base pilon fractures or fracture-dislocations surgically treated with an internal joint stabilizer.
• Data collected: time from injury to surgery, implantation to removal, complications, and range of motion.

Main Results:

• Seven patients (mean age 51 years) were included with a mean follow-up of 29 months.
• Mean arc of PIP joint motion post-removal was 8° to 88°.
• No infections, hardware failures, or revision surgeries were reported.

Conclusions:

• The internal joint stabilizer provides satisfactory functional outcomes for unstable middle phalanx base injuries.
• It allows for early postoperative motion.
• This approach mitigates common complications associated with external fixation methods.