Jp. Morgan et al., DYNAMIC DIGITAL TRACTION FOR UNSTABLE COMMINUTED INTRAARTICULAR FRACTURE-DISLOCATIONS OF THE PROXIMAL INTERPHALANGEAL JOINT, The Journal of hand surgery, 20A(4), 1995, pp. 565-573
Unstable intra-articular fracture-dislocations about the proximal inte
rphalangeal joint present a formidable management dilemma. Fourteen pa
tients with comminuted injuries of the proximal interphalangeal joint
were treated with dynamic digital traction and followed for an average
of 24 months. Dorsal fracture-dislocation and pilon-type injuries mad
e up the majority of cases. Average proximal interphalangeal joint art
icular surface involvement was 80%. Immediate motion was instituted af
ter traction application. The device was applied in the office with re
adily available materials. Al final follow-up examination, active are
of motion averaged 89 degrees at the proximal interphalangeal joint an
d 95 degrees for patients sustaining isolated injuries. X-ray films re
vealed fracture union, joint remodeling, and preservation of joint spa
ce. Patient satisfaction was high, with return to previous levels of a
ctivity and excellent functional joint restoration. Dynamic digital tr
action is recommended for unstable proximal interphalangeal joint frac
tures with comminution, including those associated with subluxation or
dislocation.