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Treatment of proximal interphalangeal joint fractures by the pins and rubbers traction system: a follow-up.

Nilsson, Jessica A and Rosberg, HansE LU (2014) In Journal of Plastic Surgery and Hand Surgery 48(4). p.259-264
Abstract
Abstract A fracture of the proximal interphalangeal (PIP) joint at the base of the middle phalanx is rare, but is a challenge to treat. Posttraumatic osteoarthritis is a known complication causing impaired hand function and disability. The aim of the present retrospective study was to evaluate characteristics and outcome of complex PIP joint fractures treated by the pins and rubbers traction system (PRTS). Medical records of 42 patients with fractures treated with a PRTS in 1999-2010 were reviewed, and followed-up by questionnaires (QuickDASH, CISS, self-composed questionnaire). Eighteen of the 42 were clinically examined. The fractures were divided into three types of fractures: volar lip, dorsal lip, and pilon fractures. The volar lip... (More)
Abstract A fracture of the proximal interphalangeal (PIP) joint at the base of the middle phalanx is rare, but is a challenge to treat. Posttraumatic osteoarthritis is a known complication causing impaired hand function and disability. The aim of the present retrospective study was to evaluate characteristics and outcome of complex PIP joint fractures treated by the pins and rubbers traction system (PRTS). Medical records of 42 patients with fractures treated with a PRTS in 1999-2010 were reviewed, and followed-up by questionnaires (QuickDASH, CISS, self-composed questionnaire). Eighteen of the 42 were clinically examined. The fractures were divided into three types of fractures: volar lip, dorsal lip, and pilon fractures. The volar lip fracture was most frequent (26/42; dorsal lip 3/42; pilon 13/42). Most fractures were sport-related (19/42; 45%) and males predominated (M:F ratio = 1.8). All fractures united. Infection occurred in 17/41 (41%) cases. Radiological signs of posttraumatic osteoarthritis were found in 25/41 (61%) patients. In 18/42 patients, where a clinical evaluation was performed, 66% of contralateral total active range of motion (TAM), 93% grip strength, and 100% pinch strength were achieved. The volar lip fracture had the best outcome according to the self-reported QuickDASH and CISS score and regained 77% of contralateral TAM. Fractures of the PIP joint in the middle phalanx can be treated with the PRTS, but reduced mobility, grip strength, infection, and osteoarthritis are seen. The device is well tolerated by the patients, easy to apply, and with ready accessible materials for the surgeon. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Journal of Plastic Surgery and Hand Surgery
volume
48
issue
4
pages
259 - 264
publisher
Taylor & Francis
external identifiers
  • pmid:24328898
  • wos:000340098000007
  • scopus:84904326822
ISSN
2000-656X
DOI
10.3109/2000656X.2013.870909
language
English
LU publication?
yes
id
e3736702-d4b3-4d37-a2ef-d6be1ced862a (old id 4224855)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24328898?dopt=Abstract
date added to LUP
2014-01-03 23:19:44
date last changed
2017-03-05 03:13:53
@article{e3736702-d4b3-4d37-a2ef-d6be1ced862a,
  abstract     = {Abstract A fracture of the proximal interphalangeal (PIP) joint at the base of the middle phalanx is rare, but is a challenge to treat. Posttraumatic osteoarthritis is a known complication causing impaired hand function and disability. The aim of the present retrospective study was to evaluate characteristics and outcome of complex PIP joint fractures treated by the pins and rubbers traction system (PRTS). Medical records of 42 patients with fractures treated with a PRTS in 1999-2010 were reviewed, and followed-up by questionnaires (QuickDASH, CISS, self-composed questionnaire). Eighteen of the 42 were clinically examined. The fractures were divided into three types of fractures: volar lip, dorsal lip, and pilon fractures. The volar lip fracture was most frequent (26/42; dorsal lip 3/42; pilon 13/42). Most fractures were sport-related (19/42; 45%) and males predominated (M:F ratio = 1.8). All fractures united. Infection occurred in 17/41 (41%) cases. Radiological signs of posttraumatic osteoarthritis were found in 25/41 (61%) patients. In 18/42 patients, where a clinical evaluation was performed, 66% of contralateral total active range of motion (TAM), 93% grip strength, and 100% pinch strength were achieved. The volar lip fracture had the best outcome according to the self-reported QuickDASH and CISS score and regained 77% of contralateral TAM. Fractures of the PIP joint in the middle phalanx can be treated with the PRTS, but reduced mobility, grip strength, infection, and osteoarthritis are seen. The device is well tolerated by the patients, easy to apply, and with ready accessible materials for the surgeon.},
  author       = {Nilsson, Jessica A and Rosberg, HansE},
  issn         = {2000-656X},
  language     = {eng},
  number       = {4},
  pages        = {259--264},
  publisher    = {Taylor & Francis},
  series       = {Journal of Plastic Surgery and Hand Surgery},
  title        = {Treatment of proximal interphalangeal joint fractures by the pins and rubbers traction system: a follow-up.},
  url          = {http://dx.doi.org/10.3109/2000656X.2013.870909},
  volume       = {48},
  year         = {2014},
}