Dynamic External Fixation for Treatment of Unstable Proximal Interphalangeal Joint Fracture-Dislocations

Abstract

Proximal interphalangeal (PIP) joint fracture-dislocations are complex injuries that pose significant challenges in hand surgery due to the joint's critical functional role and high susceptibility to stiffness and post-traumatic arthritis. These injuries involve simultaneous disruption of articular surfaces and ligamentous stabilizers, commonly resulting from axial loading, hyperextension, or high-energy trauma. Traditional treatment methods often fail to adequately balance stable reduction with early motion, leading to complications such as joint stiffness, chronic instability, and functional impairment. Dynamic external fixation using the Suzuki frame, introduced in 1994, revolutionized management by applying continuous distraction through percutaneous K-wires and elastic traction. This technique employs ligamentotaxis to maintain articular alignment while permitting early controlled motion, thereby reducing adhesion formation and preserving joint function.