īecause open reduction and fixation is difficult and may lead to fragment necrosis, closed reduction including traction systems is favored. In cases of fracture dislocation or joint subluxation, surgical treatment seems mandatory for a satisfactory result.ĭifferent surgical treatment options have been described including extension block pinning, open reduction and internal fixation (ORIF) with screws or plating, percutaneous Kirschner (K)-wire pinning after closed or mini-open reduction, and various different external traction fixation systems including K-wires, rubber bands, and springs. A palmar, a dorsal, and/or an impressed central fracture fragment can occur depending on the load transition. The middle phalanx is impacted at the head of the proximal phalanx, fracturing the articular surface of the base of the middle phalanx. This fixator is a cost-effective alternative, showing a good clinical outcome.Įxcessive axial load to the finger can cause a fracture dislocation of the proximal interaphalangeal (PIP) joint. Modifications of the radius of the parabolic construct within cases of postoperative malalignment, without anesthesia, can restore joint axis and malalignment. It allows immediate PIP joint mobilization to avoid adhesions. The use of a parabolic dynamic external fixator constructed from two K-wires restores joint alignment and stability in unstable pilonoidal PIP joint disclocation fractures. Three patients showed an osteoarthritis stage 0, five stage 1, nine stage 2, three stage 3, and one stage 4 according to the Kellgran–Lawrence Score. Twenty patients (95%) showed a concentric and stable aligned joint. Both joints could be corrected by modifying the fixator under image intensifier. One patient suffered from a recurrent dislocation, and another a subluxation of the PIP joint while wearing the fixator. The mean DASH score was 11.6 and the Buck Gramcko score 13. Patients showed very mild discomfort (mean 0.7), high patient satisfaction (mean 1.9), and a moderate acceptance (mean 2.7).
X-ray images were evaluated for bone healing, joint alignment, and signs of osteoarthritis. The active range of motion, pain level, DASH score, Buck Gramcko Score, and the patient’s satisfaction and acceptance were assessed. Twenty-one patients who sustained a pilonoidal fracture of the PIP joint and were treated with a dynamic external fixator were evaluated retrospectively. The aim of this study was to evaluate the clinical and radiological outcome of unstable fracture dislocations of the PIP treated with a parabolic dynamic external fixator consisting of two Kirschner (K)-wires. Several methods treating proximal interphalangeal joint (PIP) fracture dislocations have been established providing early joint mobilization.
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