title: Treatment of fracture subluxations of the proximal interphalangeal joint using a ligamentotaxis device: a multidisciplinary approach.
abstract: Complex fracture subluxations of the proximal interphalangeal joint are often difficult to treat and their outcome variable. A number of methods for treatment of these injuries have been described. We have used a ligamentotaxis device (Ligamentotaxor, Arex, Palaiseau Cedex, France) since 2008. We performed 28 operations in 28 patients with complex proximal interphalangeal joint injuries over a 3-year period. Patients followed a standardized postoperative rehabilitation regime, including fixator adjustment as necessary. The mean age was 33 years (range 18-67). The mean time to surgery was 7 days. At final follow-up (mean 22 months, range 6-52) the mean proximal interphalangeal joint range of motion was 85° (range 60°-110°). The mean QuickDASH functional outcome score was 4.8 (range 0-36.4). Our results compare favourably with other devices reported in the literature.
authors.affiliation: Liverpool Upper Limb Unit, Royal Liverpool University Hospital, Liverpool, UK robert.macfarlane@doctors.org.uk.
authors.forename: R J
authors.initials: RJ
authors.lastname: MacFarlane
authors.affiliation: Liverpool Upper Limb Unit, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: S
authors.initials: S
authors.lastname: Gillespie
authors.affiliation: Liverpool Upper Limb Unit, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: F
authors.initials: F
authors.lastname: Cashin
authors.affiliation: Liverpool Upper Limb Unit, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: A
authors.initials: A
authors.lastname: Mahmood
authors.affiliation: Liverpool Upper Limb Unit, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: G
authors.initials: G
authors.lastname: Cheung
authors.affiliation: Liverpool Upper Limb Unit, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005383:Finger Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005384:Finger Joint; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D016268:Internal Fixators; D057072:Intra-Articular Fractures / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004204:Joint Dislocations / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
keywords: Ligamentotaxis; fracture; multidisciplinary; proximal interphalangeal joint; subluxation