title: Extension-block pinning for fracture-dislocation of the proximal interphalangeal joint.
abstract: BACKGROUND
  Dorsal fracture-dislocation of the proximal interphalangeal joint is an unstable fracture that associates the anterior marginal fracture of the second phalangeal base and the dorsal dislocation of the proximal interphalangeal joint under the influence of the median band traction of the extensor apparatus. Stiffness and residual pain are frequent sequelae. Treatment involves choosing between the various methods with the objective of providing stable reduction allowing early mobilization.
  
  
  OBJECTIVE
  We relate our experience concerning treatment by proximal interphalangeal extension-block pinning. It consists in reduction by external manipulation and stabilization by extension-block pinning.
  
  
  METHODS
  This technique was used in 22 Trojan-type fractures. The average age of our patients was 36 years, with a predominance of males. In half of the cases, the fracture involved more than 40% of the second phalangeal articular surface.
  
  
  RESULTS
  The mean follow-up in this series was 2 years and 7 months. Assessed based on functional, clinical, and radiological criteria, the results were good in 82% of the cases. The proximal interphalangeal joint was painless and the active mobility sector mean was greater than 85°.
  
  
  CONCLUSIONS
  The dorsal dislocation fracture of the proximal interphalangeal joint is an unstable lesion. Its treatment must provide stable reduction allowing early mobilization. Various therapeutic means are described. We opted for extension-block pinning, a simple and reproducible technique with encouraging results.
  
  
  METHODS
  Level IV retrospective study.
authors.affiliation: La Rabta Teaching Hospital Center, Faculty of Medicine, Tunis, Tunisia. riadh.maalla@gmail.com
authors.forename: R
authors.initials: R
authors.lastname: Maalla
authors.forename: M
authors.initials: M
authors.lastname: Youssef
authors.forename: G
authors.initials: G
authors.lastname: Ben Jdidia
authors.forename: C
authors.initials: C
authors.lastname: Khimiri
authors.forename: H
authors.initials: H
authors.lastname: Essadam
mesh_terms: D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult