Gradual joint distraction of post-traumatic flexion contracture of the proximal interphalangeal joint by a mini-external fixator.
We present the outcome of the treatment of chronic post-traumatic contractures of the proximal interphalangeal joint by gradual distraction correction using an external fixator. A total of 30 consecutive patients with a mean age of 34 years (17 to 54) had distraction for a mean of 16 days (10 to 22). The fixator was removed after a mean of 29 days (16 to 40). Assessment at a mean of 34 months (18 to 54) after completion of treatment showed that the mean active range of movement had significantly increased by 63 degrees (30 degrees to 90 degrees ; p<0.001). The mean active extension gained was 47 degrees (30 degrees to 75 degrees ). Patients aged less than 40 years fared slightly better with a mean gain in active range of movement of 65 degrees (30 degrees to 90 degrees ) compared with those aged more than 40 years, who had a mean gain in active range of movement of 55 degrees (30 degrees to 70 degrees ) but the difference was not statistically significant (p=0.148). The use of joint distraction to correct chronic flexion contracture of the proximal interphalangeal joint is a minimally-invasive and effective method of treatment.
Houshian
S
S
Department of Orthopaedics, University Hospital Lewisham, High Street, Lewisham, London, SE13 6LH, UK. shirzad.houshian@uhl.nhs.uk
Chikkamuniyappa
C
C
Schroeder
H
H
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D002908:Chronic Disease; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D016267:External Fixators; D005260:Female; D005383:Finger Injuries / Q000150:complications*; D005384:Finger Joint / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D016059:Range of Motion, Articular; D016896:Treatment Outcome