Dynamic traction and early passive movement for fractures of the proximal interphalangeal joint

Unstable intra-articular fractures that involve the proximal and middle phalanges often lead to joint stiffness and loss of function. Ten patients with comminuted intra-articular fractures of the proximal interphalangeal (PIP) joint were treated by dynamic traction splinting and early mobilizations. Distal traction, with a force of 300 g, was provided by a rubber band connecting a transosseous wire to a movable component on an arcuate splint made of thermoplastic material. Intermittent passive movement was carried out on a timed schedule. Follow-up at 16 months (5 months to 51/2 years) showed a pain-free final range of motion (ROM) of 87 degrees (5 degrees to 92 degrees), with preservation of articular symmetry and space. this is the first report of treatment of intraarticular fractures in the hand by a combination of dynamic traction and passive movement.