Gradual joint distraction of post-traumatic flexion contracture of the proximal interphalangeal joint by a mini-external fixator

Abstract

We present the outcome of the treatment of chronic post-traumatic contractures of the proximal interphalangeal joint by gradual distraction correction using an external fixator. A total of 30 consecutive patients with a mean age of 34 years (17 to 54) had distraction for a mean of 16 days (10 to 22). The fixator was removed after a mean of 29 days (16 to 40). Assessment at a mean of 34 months (18 to 54) after completion of treatment showed that the mean active range of movement had significantly increased by 63 degrees (30 degrees to 90 degrees ; p<0.001). The mean active extension gained was 47 degrees (30 degrees to 75 degrees ). Patients aged less than 40 years fared slightly better with a mean gain in active range of movement of 65 degrees (30 degrees to 90 degrees ) compared with those aged more than 40 years, who had a mean gain in active range of movement of 55 degrees (30 degrees to 70 degrees ) but the difference was not statistically significant (p=0.148). The use of joint distraction to correct chronic flexion contracture of the proximal interphalangeal joint is a minimally-invasive and effective method of treatment.