title: [Modified Ishiguro extension block technique for fracture-dislocation of the distal interphalangeal joint].
abstract: OBJECTIVE
  Reconstruction of the anatomic configuration of the articular surface and restoration of complete movement of the finger joint.
  
  
  METHODS
  Fracture of the distal interphalangeal (DIP) joint involving > or = 30% of the articular surface. Luxation or subluxation of the distal phalanx. Fracture-dislocation > or = 2 mm.
  
  
  METHODS
  Old fractures. Closed reduction impossible.
  
  
  METHODS
  Closed reduction and pin fixation modified from Ishiguro technique without penetrating the fracture fragment.
  
  
  METHODS
  Cast fixation for 4 weeks with the finger in functional position or with the proximal interphalangeal joint flexed to relax the pulley. After 4 weeks, removal of the cast and the pin and start of active motion exercises.
  
  
  RESULTS
  Twelve patients with fracture-dislocation of the DIP joint involving more than one third of the articular surface were treated with the modified extension block technique according to Ishiguro. Time from injury to surgery was 5 days (range, 0-8 days). At a mean follow-up of 15 months (range, 9-31 months), pain on the visual analog scale (VAS, 0 = no pain, 10 = maximum pain), the active range of motion, and criteria according to Warren et al. were evaluated. Eleven patients were pain-free and one patient suffered from mild pain during strenuous work. The mean active range of motion was from -3 degrees extension (range, 0-10 degrees ) and flexion to 79 degrees (range, 45-100 degrees ). The results according to Warren et al. were very good in ten and good in two cases.
authors.affiliation: Universitätsklinik für Unfallchirurgie und Sporttraumatologie, Medizinische Universität Innsbruck, Anichstrasse 35, Innsbruck, Austria. dagmar.fritz@uki.at
authors.forename: Dagmar
authors.initials: D
authors.lastname: Fritz
authors.forename: Rohit
authors.initials: R
authors.lastname: Arora
authors.forename: Markus
authors.initials: M
authors.lastname: Gabl
authors.forename: Martin
authors.initials: M
authors.lastname: Lutz
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D001864:Bone Wires; D002370:Casts, Surgical; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005384:Finger Joint; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D013997:Time Factors; D016896:Treatment Outcome