DYNAMIC EXTERNAL FIXATION USING SUZUKI FRAME FOR PROXIMAL INTERPHALANGEAL JOINT FRACTURE DISLOCATIONS: A CASE SERIES

Abstract

Background: Fracture-dislocations of the proximal interphalangeal (PIP) joint represent highly challenging hand injuries.1 If suboptimally managed, routinely culminate in chronic pain, severe joint stiffness, and long-term functional impairment.1 By utilizing the principles of ligamentotaxis, dynamic Suzuki frame external fixator maintains a stable reduction without sacrificing early joint mobility.2 Aim: To evaluate the clinical, functional, and radiological outcomes of patients with proximal interphalangeal joint fracture-dislocations treated with Suzuki frame dynamic external fixation. Materials and Methods: This prospective case series included 15 patients with unstable PIP joint fracture-dislocations treated using a Suzuki dynamic external fixator.1 Patients with pathological fractures or severe soft-tissue injuries were excluded.2 After closed or limited open reduction under C-arm guidance, the frame was applied using Kirschner wires and elastic bands to provide dynamic distraction and stability.1,3 Early active mobilization was initiated postoperatively.3,4 Clinical and radiological follow-up assessed union, range of motion, pain, and complications Results: The mean ROM at the PIP joint at the final follow-up was 81.5 +/- 11.8 (range: 55–100) degrees. The mean flexion at the PIP joint at the final follow-up was 83.4+/- 9.5 degrees and the mean extension at the PIP joint was -1.9 +/-3.8 degrees. No case of non-union was observed in the present study. Pin tract infection occurred in 20.0% of cases (3 patients) and was the most common complication observed. One patient (6.67%) needed realignment of K-wires for pin displacement. One patient (6.67%) developed wire breakage. The same patient also developed complex regional pain syndrome (CRPS) at two months. One patient (6.67%) developed painful arthritis of the PIP joint. Conclusion: Suzuki's pin and rubber traction method is an effective modality of treatment for intra-articular fractures of the base of the proximal phalanx of fingers of the hand. Although not free of complications, the final results in most patients are good.