Distraction for proximal interphalangeal joint contractures: long-term results.

Purpose: To report the medium- to long-term outcomes of joint distraction using a unilateral external fixator in the treatment of chronic post-traumatic proximal interphalangaeal (PIP) joint contractures.

Method: Between September 2001 and October 2011, 94 consecutive patients (98 PIP joints) with a mean age of 43 years (range, 17-69 y) were treated with external fixation for chronic flexion deformity of the PIP joint from trauma. The average time from injury to surgery was 48 months (range, 6-84 mo), and the duration of joint distraction was 10 days (range, 7-22 d).

Management of posttraumatic proximal interphalangeal joint contracture.

Chronic flexion contracture of the proximal interphalangeal (PIP) joint presents a common yet challenging problem to hand surgeons. Over the years, multiple treatment modalities have been described for this problem, producing limited results. Nonoperative treatment using serial casting and splints should be tried before attempting open surgical release, which should be done in selected patients.

A new technique for closed management of displaced intra-articular fractures of metacarpal and phalangeal head delayed on presentation: report of eight cases.

We present the outcomes of the delayed management of eight displaced intra-articular fractures of the metacarpal and phalangeal heads treated with capsuloligamentotaxis using the Penning mini-external fixator. Closed anatomical reduction with a 2 mm over-distraction was achieved at the time of operation at an average of 20 days after the initial injury. Excellent outcomes in terms of function and pain were obtained at 6 month's follow-up in all cases.

Treatment of Rolando fracture by capsuloligamentotaxis using mini external fixator: a report of 16 cases.

Treatment of Rolando fractures remains a challenge for hand surgeons. We present a case series of 16 comminuted Rolando type fractures treated by controlled capsuloligamentous distraction (and over distraction by 2 mm) using the Pennig mini-external fixation system. Additional Kirschner wire(s) were used to maintain fracture reduction and stability.

Single-stage distraction correction for neglected dorsal fracture dislocations of the proximal interphalangeal joint: a report of eight cases.

We present the outcome of treatment of eight chronic neglected dorsal fracture dislocations of the proximal interphalangeal joint treated with a single-stage ligamentous distraction using the Penning mini-external fixator and a closed reduction. The distraction correction and 2 to 3 mm over distraction was performed acutely at the time of operation in all eight cases at an average injury-to-surgery time of 6 weeks. Satisfactory results with an average range of motion of 79 degrees were obtained at an average follow-up of 20 months.