Purpose
To evaluate the outcomes of extension block pinning used to treat unstable dorsal
fracture dislocations of the proximal interphalangeal (PIP) joint. The factors affecting
the functional outcome were analyzed.
Methods
A series of 53 patients with 55 dorsal fracture dislocations of the PIP joint treated
with closed reduction and extension block pinning were retrospectively reviewed. Additional
percutaneous intramedullary fracture reduction (16 cases) or open fracture reduction
(4 cases) had been performed. The radiological and clinical evaluations were included.
Results
At a mean follow-up of 5.2 years (range, 1.0–10.6 years), 39 patients with 41 injured
fingers were evaluated. The fracture fragments involved 30% to 69% (mean, 50%) of
the articular surface of the middle phalanx. The mean range of motion was 80° (range,
35° to 115°) at the PIP joint with a mean extension loss of 6° (range, 0° to 50°)
excluding 2 joints that were salvaged with arthrodesis. The mean range of motion of
the distal interphalangeal joint was 68° (range, 5° to 90°). The mean visual analog
scale for digit pain was 1.5/10. The reduction of the joint was achieved intraoperatively
in all cases. However, after the hardware removal, recurrent minimal subluxation was
observed in 12 cases (29%). Recurrent subluxation was associated with increased residual
pain. The length of follow-up time had a positive correlation, whereas the patient
age had a negative correlation with the range of motion of the injured PIP joint.
Conclusions
The extension block pinning technique is a simple and valuable technique for treating
unstable dorsal PIP fracture-dislocation injuries producing satisfactory long-term
results.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article Info
Publication History
Published online: December 22, 2015
Accepted:
November 11,
2015
Received:
April 24,
2014
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
