title: Distraction for proximal interphalangeal joint contractures: long-term results.
abstract: OBJECTIVE
  To report the medium- to long-term outcomes of joint distraction using a unilateral external fixator in the treatment of chronic post-traumatic proximal interphalangaeal (PIP) joint contractures.
  
  
  METHODS
  Between September 2001 and October 2011, 94 consecutive patients (98 PIP joints) with a mean age of 43 years (range, 17-69 y) were treated with external fixation for chronic flexion deformity of the PIP joint from trauma. The average time from injury to surgery was 48 months (range, 6-84 mo), and the duration of joint distraction was 10 days (range, 7-22 d). Patients were followed for a mean period of 54 months (range, 12-72 mo).
  
  
  RESULTS
  The average gain in joint flexion was 25° and in joint extension was 40°. The mean improvement in the active range of movement was 67° (range. 30°-90°). There was no loss of motion on the latest follow-up. Patients younger than 40 years fared slightly better than those older than 40 years. Two patients developed swelling, pain, and erythema during treatment, which resolved upon temporarily stopping the distraction process. There were 12 cases of superficial pin-site infections, which were managed conservatively without serious complications or adverse outcome.
  
  
  CONCLUSIONS
  External fixation is a simple and effective treatment modality for chronic traumatic PIP joint contractures with good predictable medium- to long-term results. Careful patient selection and monitoring are required.
authors.affiliation: Department of Orthopaedic Surgery, Braintree Community Hospital, Mid Essex, United Kingdom; The Department of Plastic Surgery, Broomfield Hospital, Chelmsford, Mid Essex, United Kingdom; Department of Orthopaedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran. Electronic address: sh_houshian@yahoo.dk.
authors.forename: Shirzad
authors.initials: S
authors.lastname: Houshian
authors.forename: Shan Shan
authors.initials: SS
authors.lastname: Jing
authors.forename: Gholam Hussein
authors.initials: GH
authors.lastname: Kazemian
authors.forename: Mohammad
authors.initials: M
authors.lastname: Emami-Moghaddam-Tehrani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D004867:Equipment Design; D016267:External Fixators; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D016059:Range of Motion, Articular; D013997:Time Factors; D016896:Treatment Outcome
keywords: Contracture; PIP joint; distraction; long-term