ABSTRACT
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.
