Abstract
Proximal interphalangeal joint pilon fractures are unstable injuries with the potential sequelae of joint pain and stiffness. The goals for surgical treatment of these injuries are to create a stable, congruent joint with fixation that allows early motion as the fracture heals. This chapter presents the case of a proximal interphalangeal joint pilon fracture that was treated with dynamic external fixation, limited open reduction and internal fixation, and extension block pinning. By combining traction with direct reduction and fixation, satisfactory reduction of the joint was achieved, and the result was functional range of motion of the joint with minimal discomfort. This case suggests that surgeons become familiar with multiple treatment techniques for these injuries and be flexible in combining these techniques as required for individual fracture patterns.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Slade JF, Baxamusa TH, Wolfe SW. External fixation of proximal interphalangeal joint fracture-dislocations. Atlas Hand Clin. 2000;5(1):1–29.
Vitale MA, White NJ, Strauch RJ. A percutaneous technique to treat unstable dorsal fracture-dislocation of the proximal interphalangeal joint. J Hand Surg Am. 2011;36(9):1453–9.
Shah CM, Sommerkamp TG. Fracture dislocation of the finger joints. J Hand Surg Am. 2014;39(4):709–802.
Williams C. Proximal interphalangeal joint fracture dislocations: stable and unstable. Hand Clin. 2012;28:409–16.
Leibovic SJ, Bowers WH. Anatomy of the proximal interphalangeal joint. Hand Clin. 1994;10(2):169–78.
Glickel SZ, Barron OA. Proximal interphalangeal joint fracture dislocations. Hand Clin. 2000;16:333–44.
Calfee RP, Sommerkamp MD. Fracture dislocation about the finger joints. J Hand Surg Am. 2009;34:1140–7.
Freiberg A. Management of proximal interphalangeal joint injuries. Can J Plast Surg. 2007;15(4):199–203.
Haase SC, Chung KC. Current concepts in treatment of fracture-dislocations of the proximal interphalangeal joint. Plast Reconstr Surg. 2014;134(6):1246–57.
Seno N, Hashizue H, Inoue H, Imatani J, Morito Y. Fractures of the base of the middle phalanx of the finger. Classification, management and long-term results. J Bone Joint Surg Br. 1997;79(5):758–63.
Kang R, Stern PJ. Fracture dislocations of the proximal interphalangeal joint. J Am Soc Surg Hand. 2002;2(2):47–59.
Liodaki E, Xing SG, Mailaender P, Stang F. Management of difficult intra-articular fracture or fracture dislocations of the proximal interphalangeal joint. J Hand Surg Eur Vol. 2015;40(1):16–23.
Elfar J, Mann T. Fracture-dislocations of the proximal interphalangeal joint. J Am Acad Orthop Surg. 2013;21:88–98.
Ng CY, Oliver CW. Fractures of the proximal interphalangeal joints of the fingers. J Bone Joint Surg Br. 2009;91:705–12.
Stern PJ, Roman RD, Kiefhaber TR, McDonough JJ. Pilon fractures of the proximal interphalangeal joint. J Hand Surg Am. 1991;16(5):844–50.
Morgan JP, Gordon DA, Klug MS, Perry PE, Barre PS. Dynamic digital traction for unstable comminuted intra-articular fracture-dislocations of the proximal interphalangeal joint. J Hand Surg Am. 1995;20(4):565–73.
Salter RB. The physiologic basis of continuous passive motion for articular cartilage healing and regeneration. Hand Clin. 1994;10(2):211–9.
Joyce KM, Joyce CW, Conroy F, Chan J, Buckley E, Carroll SM. Proximal interphalangeal joint dislocations and treatment: an evolutionary process. Arch Plast Surg. 2014;41(4):394–7.
Suzuki Y, Matsunaga T, Sato S, Yokoi T. The pins and rubbers traction system for treatment of comminuted intraarticular fractures and fracture-dislocations in the hand. J Hand Surg Br. 1994;19(1):98–107.
Hynes MC, Giddins GEB. Dynamic external fixation for pilon fractures of the interphalangeal joints. J Hand Surg Br. 2001;26(2):122–4.
Syed AA, Agarwal M, Boome R. Dynamic external fixator for pilon fractures of the proximal interphalangeal joints: a simple fixator for a complex fracture. J Hand Surg Br. 2003;28(2):137–41.
Sarris I, Goitz RJ, Sotereanos DG. Dynamic traction and minimal internal fixation for thumb and digital pilon fractures. J Hand Surg Am. 2004;29(1):39–43.
Mansha M, Miranda S. Early results of a simple distraction dynamic external fixator in management of comminuted intra-articular fractures of the base of the middle phalanx. J Hand Microsurg. 2013;5(2):63–7.
Ruland RT, Hogan CJ, Cannon DL, Slade JF. Use of dynamic distraction external fixation for unstable fracture-dislocations of the proximal interphalangeal joint injuries. J Hand Surg Am. 2008;33:19–25.
Ellis SJ, Cheng R, Prokopis P, Chetboun C, Wolfe SW, Athanasian EA, et al. Treatment of proximal interphalangeal dorsal fracture-dislocation injuries with dynamic external. J Hand Surg Am. 2007;32(8):1242.
Agarwal AK, Karri V, Pickford MA. Avoiding pitfalls of the pins and rubbers traction technique for fractures of the proximal interphalangeal joint. Ann Plast Surg. 2007;58:489–95.
Kiral A, Erken HY, Akmaz I, Yidirim C, Erler K. Pins and rubber band traction for treatment of comminuted intra-articular fractures of the hand. J Hand Surg Am. 2014;39(4):696–705.
Badia A, Riano F, Ravikoff K, Khouri R, Gonzalez-Hernandez E, Orbay JL. Dynamic intradigital external fixation for proximal interphalangeal joint fracture dislocations. J Hand Surg Am. 2005;30(1):154–60.
Allison DM. Fractures of the base of the middle phalanx treated by a dynamic external fixation device. J Hand Surg Br. 1996;21:305–10.
Finsen V. Suzuki’s pins and rubber traction for fractures of the base of the middle phalanx. J Plast Surg Hand Surg. 2010;44:209–13.
Deshmukh SC, Kumar D, Mathur K, Thomas B. Complex fracture-dislocations on the proximal interphalangeal joint of the hand: results of a modified pins and rubbers traction system. J Bone Joint Surg Br. 2004;86:406–12.
Watanabe K, Kino Y, Yajima H. Factors affective the functional results of open reduction and internal fixation for fracture-dislocations of the proximal interphalangeal joint. Hand Surg. 2015;20(1):107–14.
Waris E, Alanen V. Percutaneous, intramedullary fracture reduction and extension block pinning for dorsal proximal interphalangeal fracture-dislocations. J Hand Surg Am. 2010;35(12):2046–52.
Mangelson JJ, Stern P, Abzeg JM, Chang J, Osterman AL. Complications following dislocations of the proximal interphalangeal joint. J Bone Joint Surg Am. 2013;95:11326–32.
O’Rourke SK, Gaur S, Barton NJ. Long-term outcome of articular fractures of the phalange: an eleven year follow-up. J Hand Surg Br. 1989;14:183–93.
Blazar PE, Steinberg DR. Fractures of the proximal interphalangeal joint. J Am Acad Orthop Surg. 2000;8(6):383–90.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Kinnucan, E. (2016). Pilon Fracture of the Proximal Interphalangeal Joint: Use of a Combination of Fixation Techniques. In: Adams, J. (eds) PIP Joint Fracture Dislocations. Springer, Cham. https://doi.org/10.1007/978-3-319-28579-5_9
Download citation
DOI: https://doi.org/10.1007/978-3-319-28579-5_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-28577-1
Online ISBN: 978-3-319-28579-5
eBook Packages: MedicineMedicine (R0)