Treatment of Proximal Interphalangeal (PIP) Joint Fracture by Dynamic Kirschner Wire Fixator

Abstract

Aim: To describe the clinical outcome of treatment of proximal interphalangeal (PIP) joint fractures by dynamic Kirschner wire fixator Methods: The Kirschner wire traction fixator was used in treatment of 22 patients with pilon fracture and fracture-dislocation of proximal inter phalangeal joint. Little finger affected in eight patients, ring in three patients and middle and index fingers were affected in five and six patients respectively. The patients age at time of surgery range from 18 - 58 years (average 35.4 years). The base of proximal phalanx was involved in an average 45% (range from 35% to 70%). We used the Michigan hand score to evaluate the clinical outcome after average follow up 8 months (range from 6 - 9 months). Results: Average Michigan hand questionnaire was 88% (range from 63% - 100%). The average active flexion-extension ROM of proximal interphalangeal joint was 93 degrees (from 50 - 120 degrees). No instability or angular deformity at the end of follow up. Pin tract infection reported in four patients and two patients had moderate pain with proximal interphalangeal joint flexion more than 50 degrees. Conclusion: The Kirschner wire traction fixator was easy to apply, can reduce and maintain reduction of unstable proximal interphalangeal joint fractures and allow immediate post operative (PIP) joint motion.