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Dynamic external fixation for injuries of the proximal interphalangeal joint

Bain GI, Mehta JA, Heptinstall RJ, Bria M

The Modbury Public Hospital, Department of Orthopaedic Surgery, Adelaide, Australia.

Pain, stiffness, instability and degenerative arthritis are common sequelae of complex fracture-dislocations of the proximal interphalangeal (PIP) joint.

Operations were carried out to obtain stability, followed by application of a dynamic external fixator in 20 patients with a mean age of 29 years. This provided stability and distraction, and allowed controlled passive movement.

Most (70%) of the patients had a chronic

lesion and the mean time from injury to surgery was 215 days (3 to 1953). The final mean range of movement was 12 to 86 degrees. Complications included redislocation and septic arthritis, which affected the outcome. Four pin-track infections and two breakages of the hinge did not influence the result.

The PIP Compass hinge is a useful adjunct to surgical reconstruction of the injured PIP joint.

J Bone Joint Surg Br 1998 Nov;80(6):1014-9