Jd. Krakauer et Pj. Stern, HINGED DEVICE FOR FRACTURES INVOLVING THE PROXIMAL INTERPHALANGEAL JOINT, Clinical orthopaedics and related research, (327), 1996, pp. 29-37
Well known complications of proximal interphalangeal joint fractures a
nd fracture dislocations are stiffness, chronic instability, and degen
erative arthritis, The Compass PIP Hinge is a dynamic external fixator
that allows protected proximal interphalangeal mobilization after clo
sed reduction, open reduction and internal fixation, volar plate arthr
oplasty, or other salvage procedures, To help avoid these problems, 20
patients, 12 treated within 2 weeks of injury (Group I) and 8 treated
more than 4 weeks after injury (Group II), are reported, Articular su
rface involvement among Group I cases averaged 66% (range, 50%-90%), a
nd postoperative proximal interphalangeal motion for this group averag
ed 9 degrees to 82 degrees, Mild pain with heavy use was present in 3
patients, and 9 patients were pain free, Postoperative proximal interp
halangeal motion for Group II averaged 21 degrees to 77 degrees, Pain
was moderate to severe in 2 patients, mild with heavy use in 1 patient
, and none in 5 patients, One patient from Group II underwent surgery
to convert to a silicone proximal interphalangeal arthroplasty because
of painful degenerative arthritis, It is concluded that there is a ro
le for hinged external fixation in treating unstable proximal interpha
langeal fracture dislocations, Outcomes in acute injuries are superior
to those in chronic or salvage cases.