External dynamic fixator in treating proximal interphalangeal joints fractures

Background: Fingers proximal interphalangeal joint (PIPJ) is essential for hand function. The purpose of the study was to assess the clinical, radiological, and functional outcomes of external dynamic fixation for PIPJ fractures of the hand. Methods: This prospective cohort study performed on 30 skeletally mature patients, aged from 18 to 60 yrs old, both sexes, with comminuted, complex middle phalanx shaft/base fractures. All patients underwent medical history taking, clinical examination, and radiological assessment. Results: Grading was excellent in 6(20%) patients, good in 16 (53.33%) patients, and fair in 8(26.67%) patients. The mean arc of motion (AROM) of PIPJ was 75.9±15.48, and distal inter-phalangeal joints was 69.2±8.2. The mean grip strength was 84.1±12.69%, and the time off work was 5.1±1.84 wks. Patients were divided into two groups according to overall end results to satisfactory group (n=22), and unsatisfactory group (n=8). The surgery delay was significantly lower in satisfactory group than in unsatisfactory group ( P =0.025). Starting of motion was significantly earlier in satisfactory group than in unsatisfactory group ( P <0.001). Conclusions: External dynamic fixation for PIPJ fractures provided satisfactory outcomes in most patients with good to excellent functional results, and effective restoration of joint function. Immediate and continuous post-operative PIPJ motion improved the range of motion.