OSTEOSYNTHESIS OF INTRA-ARTICULAR FRACTURES IN THE PROXIMAL INTERPHALANGEAL JOINT WITH KIRSCHNER WIRES

Abstract

Twenty-eight consecutive patients, aged 4-68 years, who had had an intra-articular fracture of the proximal interphalangeal (PIP) joint were reviewed retrospectively in 1996. All patients were operated on within a median of three days (range 0-26). Only three patients had open injuries while 11 had fracture-dislocations. A median of half the articular surfaces were involved, and dislocations ranged from 1-4 mm. Twelve patients had their fractures anatomically reduced and 13 had postoperative dislocations of less than 1 mm. Eighteen patients were reviewed after 10-49 months, and four were interviewed by telephone. The median reduction in range of movement in the PIP joint at follow-up was 15° (range 0-90°). Nine patients had subjectively slightly reduced movements, and only three of 17 patients stated that they had limited movement. Ten patients had occasional pain, which eight described as mild and two as moderate. Two patients had ulnar instability less than 5°, and the remainder were stable. Twelve patients had a cold sensation in the affected finger joint in cold weather. No patients had changed occupation as a result of their injury, and only two patients said that they were limited in any way in any activity at work or at home. Open and precise reduction and osteosynthesis with Kirschner (K) wires seems to be an effective treatment for most intra-articular fractures of PIP joints.