chapter  9
10 Pages

Hinged Fixation and Dynamic Traction of PIP Fracture Dislocations

Any surgeon who has attempted to treat complex injuries of the

proximal interphalangeal joint (PIPJ) of a finger knows the

difficulties inherent to the task. Perhaps in no other area of

treatment in the upper extremity is the desire to achieve

“minimally invasive” management more germane. This aspira-

tion stems from the intrinsic nature of the PIPJ to become

exceedingly stiff and lose function following most open, or

“maximally invasive,” interventions. However, specific chal-

lenges must be met for such treatment to be successful. These

include establishment of a stable joint, the ability to begin active

range of motion as soon as possible, and, perhaps to a lesser

degree, restoration of joint congruity (1-3). Hinged fixation and

dynamic traction can potentially achieve these goals through

indirect joint reduction via ligamentotaxis and by providing a

construct that allows immediate range of motion.