J Korean Fract Soc.  2019 Oct;32(4):222-226. 10.12671/jkfs.2019.32.4.222.

Treatment of Neglected Proximal Interphalangeal Fracture Dislocation Using a Traction Device: A Case Report

• Cho Y
• Park JH
• Park SJ
• Lee I
• Kim E

• KMID: 2468685
• DOI: http://doi.org/10.12671/jkfs.2019.32.4.222

Abstract

This paper reports the use of a traction device for the treatment of neglected proximal interphalangeal fracture dislocations. A 44-year-old man with a fracture dislocation of a right ring finger proximal interphalangeal joint was admitted 17 days after the injury. Closed reduction and external fixation were performed using a dynamic traction device and C-arm under a brachial plexus block. Passive range of motion exercise was started after two weeks postoperatively and active range of motion exercise was started after three weeks. The traction device was removed after five weeks. No infection occurred during the traction period. No subluxation or displacement was observed on the X-ray taken two months postoperatively. The active range of motion of the proximal interphalangeal joint was 90°. The patient was satisfied with the functional result of the treatment with the traction device. The dynamic traction device is an effective treatment for neglected fracture dislocations of the proximal interphalangeal joint of a finger.

Keyword

Proximal interphalangeal joint; Fracture dislocation; Dynamic; External fixators

MeSH Terms

Adult
Brachial Plexus Block
Dislocations*
External Fixators
Fingers
Humans
Joints
Range of Motion, Articular
Traction*

Figure

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  Fig. 1 Radiographs of the middle phalanx of the ring finger show dorsal dislocation of the proximal interphalangeal joint.

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  Fig. 2 Sagittal computed tomography image of a dorsal fracture dislocation of the proximal interphalangeal joint and volar lip fracture that involves more than 50% of the articular surface.

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  Fig. 3 Postoperative radiographs show anatomic reduction of the fracture with K-wire fixation.

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  Fig. 4 Medical photos of the postoperative finger.

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  Fig. 5 Four views of hand motion. (A) Lateral view of full flexion, (B) lateral view of full extensionl, (C) pronation view of full flexion, and (D) supination view of full flexion.

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  Fig. 6 Radiographs show the union state of the middle and distal phalanx with an anatomical reduction at postoperative two months.

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