Proximal interphalangeal joint injuries can severely affect hand function. Early, active motion is important in ensuring a good range of motion and a functional outcome. Active traction splinting is a dynamic splinting system that can be performed with either open or closed reduction of phalangeal joint fractures, especially at the proximal interphalangeal level. This system allows for continued traction on the involved joint and thereby aids in providing a dynamic force that will unload the joint throughout its arc of motion and noticeably decrease pain. Early, active therapy and the continual in-line traction enables the patient to achieve an almost full range of motion early in the course of rehabilitation. This combination contributes significantly to improve patient understanding and compliance. The benefits of the active traction system are reduction of fragments, marked decrease in pain, and early range of motion with improved patient compliance. Early, active motion facilitates improved joint nutrition, contouring, and healing. Active traction splinting for proximal interphalangeal joint injuries is a relatively simple and effective method for treating these complex injuries.