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Hinged device for fractures involving the proximal interphalangeal joint
1Department of Orthopaedic Surgery, University of Cincinatti, OH, USA.
Clinical Orthopaedics and Related Research
|June 1, 1996
Summary
The Compass PIP Hinge dynamic external fixator aids proximal interphalangeal joint (PIPJ) fracture-dislocation treatment. Early intervention with this device yields superior outcomes compared to delayed or salvage cases.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Biomedical Engineering
Background:
- Proximal interphalangeal (PIP) joint fractures and dislocations can lead to stiffness, instability, and arthritis.
- The Compass PIP Hinge is a dynamic external fixator designed for protected PIP joint mobilization.
- This device is applicable after various surgical interventions for PIP joint injuries.
Purpose of the Study:
- To evaluate the efficacy of the Compass PIP Hinge in treating proximal interphalangeal joint (PIPJ) fracture-dislocations.
- To compare outcomes between acute (<2 weeks) and chronic (>4 weeks) PIPJ fracture-dislocation treatment using the Compass PIP Hinge.
- To assess the impact of the device on joint mobility, pain, and the incidence of complications.
Main Methods:
- A retrospective case series of 20 patients with PIPJ fracture-dislocations treated with the Compass PIP Hinge.
- Patients were divided into two groups: Group I (acute, n=12) treated within 2 weeks of injury, and Group II (chronic/salvage, n=8) treated more than 4 weeks post-injury.
- Outcomes measured included postoperative PIP joint motion, pain levels, and need for further surgical intervention.
Main Results:
- Group I (acute) demonstrated an average postoperative PIP motion of 9-82 degrees, with 9/12 patients pain-free.
- Group II (chronic/salvage) showed average postoperative PIP motion of 21-77 degrees, with 5/8 patients pain-free.
- One patient in Group II required conversion to silicone arthroplasty due to degenerative arthritis; mild pain with heavy use was reported in others.
Conclusions:
- Hinged external fixation, specifically the Compass PIP Hinge, has a role in managing unstable proximal interphalangeal joint fracture-dislocations.
- Acute PIPJ injuries treated with the Compass PIP Hinge show superior functional outcomes and reduced pain compared to chronic or salvage cases.
- Early application of dynamic external fixation may help prevent long-term complications like stiffness and arthritis in PIPJ injuries.