Hand-Specific External Fixation for Treatment of Complex Proximal Interphalangeal Joint Injuries

Background Complex proximal interphalangeal joint (PIP]) fractures are challenging injuries to treat. There are multiple established treatment methods available for these injuries, including dynamic external fixation. This study reports the outcomes of complex PIP] fractures treated with a hand-specific external fixation device. Methods Twenty-five fingers in 25 patients were treated with the DigiFix external fixator device for treatment of a PIP] dorsal fracture dislocation (n = 16) or pilon fracture (n = 9) . There were 16 males and 9 females with a mean age of 40 years (range: 14-75 years) at the time of injury. The median time from injury to surgery was 10 days (interquartile range [IQR]: 5; range: 3-49). Chart and radiographic data were reviewed retrospectively. Results The average duration of external fixation was 41 days (range: 26-62 days). At a mean follow-up of 28 weeks (range: 12-105 weeks), the mean PIP] flexion was 82 (range: 30-105 degrees), extension was -10 degrees (range: -30 to 0 degrees), and flexion/extension arc of motion was 72 degrees (range: 30-95 degrees). Final mean Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score was 21.5 (range: 0-65.8). There were zero major complications and six (24%) minor complications, including superficial cellulitis (4) and stiffness (2). Conclusion Dynamic external fixation for the treatment of complex PIP] injuries allows for early range of motion and leads to favorable outcomes. This hand-specific external fixator has a reproducible technique which results in predictable and reliable PIPJ distraction.