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KMID : 0386420190320010001
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Journal of the Korean Fracture Society
2019 Volume.32 No. 1 p.1 ~ p.5
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Use of a Distraction Dynamic External Fixator in the Treatment of Comminuted Middle Phalanx Base Fractures
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Kim Sang-Woo
Lee Chae-Chil
Ko Sang-Hun
Hwang Il-Yeong
Kim Min-Seok
Jin Woo-Jung
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Abstract
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Purpose: This paper suggests the use of distraction dynamic external fixators (DDEF) for the treatment of proximal middle phalanx fractures.
Materials and Methods: Seven patients, who were diagnosed with comminuted intra-articular fractures at the base of the middle phalanx from February 2014 to November 2016, were enrolled in this study (volar aspect 6 cases, dorsal aspect 1 case). They underwent a closed reduction under a C-arm image intensifier, and DDEF was applied with general anesthesia. Range of motion (ROM) exercise was encouraged after 3 to 5 days postoperatively, and DDEF was removed after 5 weeks. Subluxation, angulation and displacement were evaluated 6 weeks postoperatively.
Results: The patients who were treated with DDEF showed a normal proximal interphalangeal joint ROM (100°), and there was no subluxation or displacement on the X-ray film 6 weeks postoperatively. In addition, there were no signs of infection, such as local heat, redness, and pus-like discharge.
Conclusion: DDEF helps maintain the reduction and reducing forces through the ligamentotaxis. The joint stiffness is reduced, which it makes early return to daily life easier.
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KEYWORD
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Proximal phalanx, Phalangeal pilon fracture, Distraction dynamic external fixator, Kirschner wires
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