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Ahangar, Parviz, Rahimnia, Alireza, Mokhtari, Masoud, Rahimnia, Amirhossien. (1400). Treatment of Fracture-Dislocations of Proximal Interphalangeal Joint by Applying of Dynamic Mini External Fixator: Clinical and Radiographic Results. , 9(6), 695-701. doi: 10.22038/abjs.2021.54249.2709
Parviz Ahangar; Alireza Rahimnia; Masoud Mokhtari; Amirhossien Rahimnia. "Treatment of Fracture-Dislocations of Proximal Interphalangeal Joint by Applying of Dynamic Mini External Fixator: Clinical and Radiographic Results". , 9, 6, 1400, 695-701. doi: 10.22038/abjs.2021.54249.2709
Ahangar, Parviz, Rahimnia, Alireza, Mokhtari, Masoud, Rahimnia, Amirhossien. (1400). 'Treatment of Fracture-Dislocations of Proximal Interphalangeal Joint by Applying of Dynamic Mini External Fixator: Clinical and Radiographic Results', , 9(6), pp. 695-701. doi: 10.22038/abjs.2021.54249.2709
Ahangar, Parviz, Rahimnia, Alireza, Mokhtari, Masoud, Rahimnia, Amirhossien. Treatment of Fracture-Dislocations of Proximal Interphalangeal Joint by Applying of Dynamic Mini External Fixator: Clinical and Radiographic Results. , 1400; 9(6): 695-701. doi: 10.22038/abjs.2021.54249.2709

Treatment of Fracture-Dislocations of Proximal Interphalangeal Joint by Applying of Dynamic Mini External Fixator: Clinical and Radiographic Results

The Archives of Bone and Joint Surgery
مقاله 11، دوره 9، شماره 6، بهمن 2021، صفحه 695-701    اصل مقاله (739.59 K)
نوع مقاله: RESEARCH PAPER
شناسه دیجیتال (DOI): 10.22038/abjs.2021.54249.2709
نویسندگان
Parviz Ahangar1؛ Alireza Rahimnia* 1؛ Masoud Mokhtari2؛ Amirhossien Rahimnia3
11 Department of Orthopedic Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran. 2 Trauma Research center, Department of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
2Department of Orthopedic Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
3Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran
چکیده
Background: Fracture-dislocations of the proximal interphalangeal joint of fingers are believed to be challenging injuries that usually lead to residual pain and stiffness. To date, several treatment options have been applied. Dynamic traction-external fixation is a safe and easy technique offering good results in many works of literature. The dynamic mini external fixator using K-wires and mini rods provide sufficient dynamic traction and facilitate early mobilization of the injured joint. The present study was conducted to evaluate the results of a dynamic mini external fixator for the treatment of those lesions. Methods: In total, 40 patients who suffered from proximal interphalangeal fracture-dislocations were treated at our institution between November 2017 and November 2019. Dynamic mini external fixator device was utilized for their treatment. Clinical and radiographic parameters were evaluated at 2, 4, 6, 12, and 24 weeks after surgery. Results: This study included 30 (75%) males and 10 (25%) females with a mean age of 38.7±9.9 years. In total, 6 (15%) patients had concomitant fractures or fractures in their hands. All the fractures, including 27 (67.5%) dorsal fracture-dislocations and 13 (32.5%) Pilon fractures, were united without the occurrence of any malunion or major residual subluxation. One Pilon fracture needed to be realigned by reassembling the device at the second week of follow-up. Furthermore, 36 (90%) patients achieved full range of joint motion, and 4 (10%) patients had mild loss of motion arc. In addition, 8 (20%) patients developed mild pin site infection treated with oral antibiotics without device removal. Following six months, one (2.5%) patient mentioned minimal residual pain. Conclusion: The dynamic mini external fixator was found to be a safe and applicable technique to manage proximal interphalangeal fracture-dislocations. To obtain significantly accurate results, regular follow-up and accurate device care are of great necessity. Level of evidence: IV
کلیدواژه‌ها
Articular؛ Early ambulation and range of motion؛ External fixators؛ Finger joint؛ Fracture dislocation
مراجع
1. Aladin A, Davis TR. Dorsal fracture-dislocation of the proximal interphalangeal joint: a comparative study of percutaneous Kirschner wire fixation versus open reduction and internal fixation. J Hand Surg Br. 2005 May;30(2):120-8. doi: 10.1016/j.jhsb.2004.10.011. PMID: 15757762.
2. Mabvuure NT, Pinto-Lopes R, Sierakowski A. Management of intraarticular proximal interphalangeal joint fracture-dislocations and pilon fractures with the Ligamentotaxor® device. Arch Orthop Trauma Surg. 2020 Aug;140(8):1133-1141. doi: 10.1007/s00402-020-03482-8. Epub 2020 May 25. PMID: 32448930.
3. Kastenberger T, Kaiser P, Keller M, Schmidle G, Gabl M, Arora R. Clinical and radiological midterm outcome after treatment of pilonoidal fracture dislocations of the proximal interphalangeal joint with a parabolic dynamic external fixator. Arch Orthop Trauma Surg. 2020 Jan;140(1):43-50. doi: 10.1007/s00402- 019-03275-8. Epub 2019 Sep 5. PMID: 31486856; PMCID: PMC6942001.
4. Kostoris F, Canton G, Longo E, Romano F, Murena L. Treatment of dorsal fracture-dislocation of the proximal interphalangeal joint using the Ligamentotaxor device: clinical and radiographic preliminary results. Acta Biomed. 2017 Oct 18;88(4S):90-95. doi: 10.23750/abm.v88i4-S.6799. PMID: 29083359; PMCID: PMC6357656.
5. Seno N, Hashizume H, Inoue H, Imatani J, Morito Y. Fractures of the base of the middle phalanx of the finger. Classification, management and long-term results. J Bone Joint Surg Br. 1997 Sep;79(5):758-63. doi: 10.1302/0301-620x.79b5.7664. PMID: 9331031.
6. Watanabe K, Kino Y, Yajima H. Factors affecting the functional results of open reduction and internal fixation for fracture-dislocations of the proximal interphalangeal joint. Hand Surg. 2015;20(1):107-14. doi: 10.1142/S021881041550015X. PMID: 25609283.
7. Kubitskiy A, Soliman BA, Dowd MB, Curtin P. External fixation of the hand: a simple approach to comminuted proximal interphalangeal joint fractures. Hand Surg. 2014;19(1):85-9. doi: 10.1142/S0218810414500142. PMID: 24641746.
8. Colegate-Stone T, Marenah K, Compson J, Tahmassebi R, Tavakkolizadeh A. Functional Outcomes Following Pilon Fractures of the Middle Phalanx Managed with the Ligamentotaxor External Fixator. Hand Surg. 2015;20(2):285-9. doi: 10.1142/S0218810415500252. PMID: 26051770.
9. Hamilton LC. The Acute Management of Unstable Intra-Articular Fractures of the Base of the Middle Phalanx: A Systematic Review. J Hand Surg Asian Pac Vol. 2018 Dec;23(4):441-449. doi: 10.1142/S2424835518300037. PMID: 30428786.
10. Adams JE, Calfee RP, Vitale MA, Strauch RJ, Barron OA. Dorsal proximal interphalangeal joint fracture-dislocations: evaluation and treatment. Instr Course Lect. 2015;64:261-72. PMID: 25745912.
11. MacFarlane RJ, Gillespie S, Cashin F, Mahmood A, Cheung G, Brown DJ. Treatment of fracture subluxations of the proximal interphalangeal joint using a ligamentotaxis device: a multidisciplinary approach. J Hand Surg Eur Vol. 2015 Oct;40(8):825-31. doi: 10.1177/1753193415578305. Epub 2015 Jun 8. PMID: 26056129.
12. Agee JM. Unstable fracture dislocations of the proximal interphalangeal joint. Treatment with the force couple splint. Clin Orthop Relat Res. 1987 Jan;(214):101-12. PMID: 3791731.
13. Deshmukh SC, Kumar D, Mathur K, Thomas B. Complex fracture-dislocation of the proximal interphalangeal joint of the hand. Results of a modified pins and rubbers traction system. J Bone Joint Surg Br. 2004 Apr;86(3):406-12. doi: 10.1302/0301-620x.86b3.14350. PMID: 15125130.
14. Hynes MC, Giddins GE. Dynamic external fixation for pilon fractures of the interphalangeal joints. J Hand Surg Br. 2001 Apr;26(2):122-4. doi: 10.1054/jhsb.2000.0521. PMID: 11281662.
15. Inanami H, Ninomiya S, Okutsu I, Tarui T. Dynamic external finger fixator for fracture dislocation of the proximal interphalangeal joint. J Hand Surg Am. 1993 Jan;18(1):160-4. doi: 10.1016/0363-5023(93)90265-5. PMID: 8423305.
16. Majumder S, Peck F, Watson JS, Lees VC. Lessons learned from the management of complex intra-articular fractures at the base of the middle phalanges of fingers. J Hand Surg Br. 2003 Dec;28(6):559-65. doi: 10.1016/s0266-7681(03)00139-6. PMID: 14599828.
17. Morgan JP, Gordon DA, Klug MS, Perry PE, Barre PS. Dynamic digital traction for unstable comminuted intra-articular fracture-dislocations of the proximal interphalangeal joint. J Hand Surg Am. 1995 Jul;20(4):565-73. doi: 10.1016/S0363-5023(05)80268-0. PMID: 7594279.
18. Schenck RR. The dynamic traction method. Combining movement and traction for intra-articular fractures of the phalanges. Hand Clin. 1994 May;10(2):187-98. PMID: 8040197.
19. Suzuki Y, Matsunaga T, Sato S, Yokoi T. The pins and rubbers traction system for treatment of comminuted intraarticular fractures and fracture-dislocations in the hand. J Hand Surg Br. 1994 Feb;19(1):98-107. doi: 10.1016/0266-7681(94)90059-0. Erratum in: J Hand Surg [Br] 1994 Jun;19(3):408. PMID: 8169490.
20. Sastravaha N, Limudomporn K, Taweewuthisub W. A Novel Technique for Dynamic External Fixation of Proximal Interphalangeal Joint Fracture-Dislocations. J Hand Surg Asian Pac Vol. 2020 Dec;25(4):427-433. doi: 10.1142/S2424835520500460. PMID: 33115354.
21. Dahl MT, Gulli B, Berg T. Complications of limb lengthening. A learning curve. Clin Orthop Relat Res. 1994 Apr;(301):10-8. PMID: 8156659.
22. Kleinert HE, Verdan C. Report of the Committee on Tendon Injuries (International Federation of Societies for Surgery of the Hand). J Hand Surg Am. 1983 Sep;8(5 Pt 2):794-8. doi: 10.1016/s0363-5023(83)80275-5. PMID: 6630960.
23. Kodama A, Sunagawa T, Nakashima Y, Shinomiya R, Hayashi Y, Ochi M, Adachi N. Joint distraction and early mobilization using a new dynamic external finger fixator for the treatment of fracture-dislocations of the proximal interphalangeal joint. J Orthop Sci. 2018 Nov;23(6):959-966. doi: 10.1016/j.jos.2018.07.013. Epub 2018 Aug 9. PMID: 30100212.
24. Ruland RT, Hogan CJ, Cannon DL, Slade JF. Use of dynamic distraction external fixation for unstable fracture-dislocations of the proximal interphalangeal joint. J Hand Surg Am. 2008 Jan;33(1):19-25. doi: 10.1016/j.jhsa.2007.07.018. PMID: 18261660.
25. Abou Elatta MM, Assal F, Basheer HM, El Morshidy AF, Elglaind SM, Abdalla MA. The use of dynamic external fixation in the treatment of dorsal fracture subluxations and pilon fractures of finger proximal interphalangeal joints. J Hand Surg Eur Vol. 2017 Feb;42(2):182-187. doi: 10.1177/1753193416674155. Epub 2016 Oct 22. PMID: 27756830.
26. Kremer L, Frank J, Lustenberger T, Marzi I, Sander AL. Epidemiology and treatment of phalangeal fractures: conservative treatment is the predominant therapeutic concept. Eur J Trauma Emerg Surg. 2020 May 25. doi: 10.1007/s00068-020-01397-y. Epub ahead of print. PMID: 32451567. worth Pub. Co; 1973. 383 p.

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