Abstract
Background and objectiveFractures of the proximal interphalangeal joint (PIPJ) of the hand have always been difficult to treat, often leading to less than satisfactory outcomes. The use of dynamic external fixator devices to treat these fractures is well established and it is based on the philosophy of minimal soft tissue injury and early joint mobilization. There has been a wide variety in their designs, surgical technique, and reported outcomes. This study aimed to report the long-term outcome following the use of the Ligamentotaxor® device (Ligamentotaxor1, ArexTM, Palaiseau, France) in treating fractures of the PIPJ of the hand.MethodsBetween 2009 and 2018, 33 patients treated in our institution with Ligamentotaxor® for fractures of the PIPJ were followed up for a minimum period of 12 months. Radiographs and clinical records were reviewed for clinical and functional outcomes including finger range of motion (ROM), union, Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) score, and any complications.ResultsA total of 33 patients completed a minimum follow-up of 12 months (mean: 27.5 months). All fractures showed radiological union at a mean of 33 days. Surgery was performed within a mean of 8.9 days and surgical operating time averaged 23.7 minutes. Devices were removed at a mean of 33 days. At the end of the follow-up, the mean range of flexion was 66 degrees and the mean extension lag was six degrees. The mean QuickDASH score was 8.72. Of note, 85% of the patients experienced no limitations in their daily activities, while 35% reported pain on exertion. One patient had a pin tract infection. Four patients had cold intolerance and persistent swelling.ConclusionThe results of the use of Ligamentotaxor® in this series are comparable to those of other dynamic external fixator devices reported in the literature. Thanks to its quick and easy surgical technique, the device provides an appealing option for the management of PIPJ fractures.
Highlights
Proximal interphalangeal joint (PIPJ) fractures of the hand are often difficult to manage, often resulting in less than satisfactory outcomes. The notoriety of these fractures is attributed to long-term complications such as stiffness, arthritis, and persistent pain [1]. Anatomic reduction of these fractures has not been shown to correlate with clinical outcomes, and the priority is to achieve well-aligned, reduced joint, and to initiate early range of motion (ROM) to promote cartilage healing [2]
They all share the philosophy of ligamentotaxis where soft tissue tension is used to reduce fractures and distract joint surfaces allowing for early joint mobilization [4,5]
We report the outcome of using the relatively newly designed Ligamentotaxor® device (Ligamentotaxor1, ArexTM, Palaiseau, France) in treating 33 patients with unstable intraarticular PIPJ fracture-dislocations at a single institution and comparing their outcomes to reports of the outcomes of other dynamic external fixators in the literature
Summary
Proximal interphalangeal joint (PIPJ) fractures of the hand are often difficult to manage, often resulting in less than satisfactory outcomes. The notoriety of these fractures is attributed to long-term complications such as stiffness, arthritis, and persistent pain [1]. There has been a vast array of different devices with different surgical techniques, designs, and outcomes They all share the philosophy of ligamentotaxis where soft tissue tension is used to reduce fractures and distract joint surfaces allowing for early joint mobilization [4,5]. This study aimed to report the long-term outcome following the use of the Ligamentotaxor® device (Ligamentotaxor, ArexTM, Palaiseau, France) in treating fractures of the PIPJ of the hand
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
