Modified Dynamic Suzuki Wire Frame for Proximal Interphalangeal Joint Fracture – A Case Report
Abstract
Complex comminuted fractures of the base of the middle phalanx, proximal phalanx and proximal interphalangeal joint are a treatment challenge, as deformity, stiffness and loss of function are quite frequent and disabling, following surgical treatment. We present a case of a 31-year male who suffered from comminuted intra-articular fracture and dislocation of the middle phalangeal base of the little finger and middle finger of the same hand, a year apart. Both were closed injuries of the dominant hand. We used a modified dynamic Suzuki wire frame for treatment of both fractures in an acute setting and at late presentation for the middle finger and little finger respectively. Minimal soft tissue injury, capsulo-ligamentotaxis, early mobilisation with frame and early return to function were key aspects of this treatment. Modified dynamic Suzuki frame is a simple, minimally invasive, dynamic external fixation device, that allows early motion at PIPJ and eventually good remodelling and function at PIPJ and DIPJ, even in the long term. It can be used in modified forms for comminuted fractures of bases of distal and proximal phalanges as well.
References
2. Swanson AB. Fractures involving the digits of the hand. Orthop Clin North Am 1970;1(2): 261–74.
3. Van Onselen EB, Karim RB, Hage JJ, et al. Prevalence and distribution of hand fractures. J Hand Surg Br 2003;28(5):491–5.
4. Keramidas E, Solomos M, Page RE, et al. The Suzuki frame for complex intra-articular fractures of the proximal interphalangeal joint of the fingers. Ann Plast Surg 2007;58(5):484- 488.
5. Salter RB, Simmonds DF, Malcolm BW, et al. The biological effect of continuous passive motion on the healing of fullthickness defects in articular cartilage. An experimental investigation in the rabbit. J Bone Joint Surg Am 1980;62(8):1232- 1251.
6. Ellis, SJ, Cheng, R, Prokopis, P. Treatment of proximal interphalangeal dorsal fracture-dislocation injuries with dynamic external fixation: a pins and rubber band system. J Hand Surg 2007; 32A: 1242–1250.
7. Inanami, H, Ninomiya, S, Okutsu, I. Dynamic external finger fixator for fracture dislocation of the proximal interphalangeal joint. J Hand Surg Am 1993; 18: 160–164.
8. Majumder, S, Peck, F, Watson, JS. Lessons learned from the management of complex intra-articular fractures at the base of the middle phalanges of fingers. J Hand Surg Br 2003; 28: 559–565.
9. Schenck RR. Classification of fractures and dislo- cations of the proximal interphalangeal joint. Hand Clin 1994;10(2):179– 85.
10. Stern, PJ, Roman, RJ, Kiefhaber, TR. Pilon fracture of the proximal interphalangeal joint. J Hand Surg Am 1991; 16: 844–850.
11. Boussakri H, Elibrahimi A and Elmrini A. Dynamic Distraction External Fixation Derived from the SUZUKI Frame for Pip Joint Fractures. SM J Orthop. 2015;1(5):1025.
12. Suzuki, Y, Matsunaga, T, Sato, S. Pins and rubbers traction system for treatment of comminuted intraarticular fractures and fracture-dislocations in the hand. J Hand Surg Br 1994; 19: 98–107.
13. Deshmukh, SC, Kumar, D, Mathur, K. Complex fracturedislocation of the proximal interphalangeal joint of the hand. Results of a modified pins and rubbers traction system. J Bone Joint Surg Br 2004; 86: 406–412.
14. Slade, JF, Baxamusa, TH, Wolfe, SW. External fixation of proximal interphalangeal joint fracture-dislocations. Atlas Hand Clin 2000; 5: 1–29.
15. Nanno M, Kodera N, Tomori Y, Takai S. Pins and rubbers traction system for fractures of the proximal interphalangeal joint. J Orthop Surg (Hong Kong). 2019 May- ug;27(2)
16. Richter M et al. Long-term follow-up of fracture dislocations and comminuted fractures of the PIP joint treated with Suzuki’s pin and rubber traction system. Handchir Mikrochir Plast Chir. 2008 Oct;40(5):330-5. German.
