Purpose This study aims to evaluate the functional, clinical and radiological outcome of treatment of fractures of proximal inter-phalangeal jointsof hand by Suzuki frame external fixator technique.
Patients and Methods
A prospective study was held in Benha university hospital including 20 patients with intraarticular PIPJ fractures treated with Suzuki frame external fixator technique. All the patients were followed up for a minimum period of 12 weeks and the maximum period of follow up was 36 weeks. Post operatively, Plain radiographs were used for assessing fracture reduction, congruity and healing. The visual analogue score (VAS) and the Michigan Hand Outcome Questionnaire (MHQ) were used for functional evaluation. PIPJ range of motion (ROM) and hand grip strength were also assessed.
Results
The mean age of the studied patients was 33.85 ± 8.65 years and there was a male predominance (75%). The left hand was affected in 12 patients (60%). The non-dominant hand was involved in 13 patients (65). The mechanisms of injury were crushing by hard object (45%), followed by falling on the ground (35%), and Sport injury (20%).The mean time from injury was 2.05±1.88 days. The mean time of surgery was 17.55 ±3.1 minutes. The mean time of the bony union was 11.8±2.9 weeks. The mean time of the frame removal was 4.7± 0.57 weeks. At the final follow-up, all patients had no residual pain. The average PIPJ-ROM was 86.25 ± 9.6°, and the average grip-strength was 89.9 ± 8.19% as compared to the healthy side. The mean normalized MHQ score was 86.1±11.26 points, with 7, 10, and 3 patients had excellent, good, and fair results retrospectively. Complications included pin tract infection (three cases), stiffness (one case), aseptic loosening and osteolysis at head of proximal phalanx (one case), and flexion contractures (one case).
Conclusion
The pins and rubber traction frame technique is simple, reliable, available, reproducible, time-saving and cost-effective for managing complex PIPJ fractures while allowing early joint mobilization, which proven effective in achieving high satisfactory functional results. |
