External immobilization of index finger collateral ligament injuries using an improvised frame

Abstract

Background: Proximal interphalangeal joint (PIPJ) dislocation is a common injury. Current management of instability after closed reduction is repair of the torn ligament followed by immobilization. Important sequelsafter prolonged immobilization include stiffness. On the other hand, early motion exercise may cause rerupture. Buddy taping has been used to partially stabilize the injured finger which also allows early gentle motion.However, this technique cannot be applied to collateral ligament injury of a border finger such as the radial collateral ligament of the index or ulnar collateral ligament of the little finger. Objectives: To describe functional outcomes after application of a frame improvised from a standard disposable syringe in cases of index radial collateral ligament injury. Methods: We constructed adjustable, customized, mobile frames improvised from standard disposable syringe barrels for stabilizing collateral ligaments of the PIPJ to improve motion and protect the repaired ligament. Twopatients with radial collateral ligament injury of the index finger were treated with the improvised frame for 4 weeks after an initial 3-week immobilization with Kirschner wire and a static splint. Results: The average range of motion of PIPJ after treatment was 0-105 with good radioulnar stability. The lifetime of the improvised frame is approximately 8 days, but it can be replaced easily and inexpensively inmost medical facilities. Conclusions: We introduce an improvised which we call a Sriracha frame, as a novel, inexpensive, easyto produce, and effective device that yields good, early joint motion and stability. Keywords: External immobilization, index finger, proximal interphalangeal joint