Pilon fractures of the proximal interphalangeal joint.
A pilon fracture is an uncommon intraarticular fracture of the proximal interphalangeal (PIP) joint resulting in comminution, central depression, and splay, sagittally and coronally, of the articular surface of the base of the middle phalanx. This study reviews three treatment methods and results in 20 patients. Injury was produced by an axial load and occurred primarily to the ulnar digits. Clinical and radiographic follow-up averaged 25 months. Treatment was divided into three categories: splint (four patients), skeletal traction through the middle phalanx (seven patients), and open reduction with Kirschner pins (nine patients). Anatomic restoration of PIP articular contour was not achieved, regardless of technique. No patient regained full mobility at either interphalangeal joint. Treatment by immobilization is undesirable. Open reduction should be approached cautiously and may result in significant complications. Skeletal traction is safe and gives results that are radiographically and clinically comparable to those achieved with open reduction.
Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Ohio.
P J
PJ
Stern
R J
RJ
Roman
T R
TR
Kiefhaber
J J
JJ
McDonough
D000328:Adult; D001858:Bone Nails; D005260:Female; D005383:Finger Injuries / Q000628:therapy*; D005384:Finger Joint; D005592:Fracture Fixation; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000628:therapy*; D006801:Humans; D008297:Male; D013165:Splints; D014143:Traction