Treatment of intra-articular phalangeal fractures of the hand by Suzuki frame external fixator

Abstract

Purpose This study aims to evaluate the functional, clinical, and radiological outcome of treatment of fractures of proximal interphalangeal joints of the hand by the Suzuki frame external fixator technique. Patients and methods A prospective study was held in Benha University Hospital that included 20 patients with intra-articular proximal interphalangeal joint (PIPJ) fractures treated with the Suzuki frame external fixator technique. All of the patients were followed up for a minimum period of 12 weeks, and the maximum period of follow-up was 36 weeks. Postoperatively, plain radiographs were used for assessing fracture reduction, congruity, and healing. The visual analog score and the Michigan Hand Outcome Questionnaire were used for functional evaluation. PIPJ range of motion and hand grip strength were also assessed. Results The mean age of the studied patients was 33.85 ± 8.65 years, and there was a male predominance (75%). The left hand was affected in 12 (60%) patients. The nondominant hand was involved in 13 (65%) patients. The mechanisms of injury were crushing by hard object (45%), followed by falling on the ground (35%), and sports injury (20%). The mean time from injury was 2.05 ± 1.88 days. The mean time of surgery was 17.55 ± 3.1 min. The mean time of the bony union was 11.8 ± 2.9 weeks. The mean time of the frame removal was 4.7 ± 0.57 weeks. At the final follow-up, all patients had no residual pain. The average PIPJ-range of motion was 86.25 ± 9.6°, and the average grip strength was 89.9 ± 8.19% as compared with the healthy side. The mean normalized Michigan Hand Outcome Questionnaire score was 86.1 ± 11.26 points, with seven, 10, and three patients having excellent, good, and fair results, respectively. Complications included pin-tract infection (three cases), stiffness (one case), aseptic loosening and osteolysis at head of proximal phalanx (one case), and flexion contractures (one case). Conclusion The pins and rubber traction frame technique is simple, reliable, available, reproducible, time saving, and cost-effective for managing complex PIPJ fractures while allowing early joint mobilization, which is proven to be effective in achieving high satisfactory functional results.