Unstable Middle Phalanx Base Fractures Treated With an Internal Joint Stabilizer: Preliminary Results

• Published in: Hand (New York, N.Y.) Vol. 19; no. 6; pp. 941 - 945
• Main Authors: Klein, David M., Teytelbaum, David E., Patel, Jay S., Combs, Taylor E., Heifner, John J., Orbay, Jorge L.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.09.2024
• Subjects: Adult; Aged; Female; Finger Injuries - surgery; Finger Joint - physiopathology; Finger Joint - surgery; Finger Phalanges - injuries; Finger Phalanges - surgery; Fracture Dislocation - surgery; Fracture Fixation, Internal - instrumentation; Fracture Fixation, Internal - methods; Fractures, Bone - surgery; Humans; Joint Instability - physiopathology; Joint Instability - surgery; Male; Middle Aged; Range of Motion, Articular; Retrospective Studies; Young Adult; internal joint stabilizer; PIP fracture; PIP dislocation; unstable PIP
• ISSN: 1558-9447; 1558-9455; 1558-9455
• DOI: 10.1177/15589447231160210

Background: Unstable fractures of the base of the middle phalanx are notorious for causing chronic loss of proximal interphalangeal (PIP) joint function, and they remain a challenge for the hand surgeon. We report on a temporary intraoperatively constructed internal joint stabilizer for unstable PIP joint injuries. Methods: Across 2 institutions, a retrospective chart review was performed for cases with acute presentation of pilon fracture or fracture-dislocation of the base of the middle phalanx which were surgically treated with an internal joint stabilizer. Information collected included time from injury to surgical intervention, time from implantation to device removal, complications, and preoperative and postoperative range of motion. Results: Seven patients met the inclusion criteria with a mean age of 51 (range: 24-72) years and a mean follow-up of 29 (range: 11-72) months. After removal of the fixator, the mean arc of PIP joint motion was 8° to 88° (range: 0°-100°). There were no infections, no hardware loosening or failures, and no revision procedures. Conclusion: The current findings are comparable to the results for dynamic external fixators. An internal joint stabilizer for unstable injuries to the base of the middle phalanx provides satisfactory functional outcomes, allows early postoperative motion, and mitigates the routine complications which may arise with external fixation.