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Biomechanical and functional analysis of the pins and rubbers tractions system for treatment of proximal interphalangeal joint fracture dislocations

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Dynamic external fixation systems are considered as optimal devices for treatment of fracture dislocations of the proximal interphalangeal joint (PiP). The pins and rubbers traction system (PRTS) is cheap, easy to assemble and comfortable and allows early mobilization of the affected digit. We investigated the influence of different wire positions and rubber strength and provided a follow-up of five consecutively treated patients.

Methods

Sixteen cadaver fingers (dig 2–5) were included into the biomechanical study. Forces for flexion of the PiP joint (30°, 60°, and 90°) were measured by pulling the flexor digitorum profundus tendon; width of the PiP joint was assessed radiologically. Measurements were obtained prior and after assembly of PRTS and were repeated with three different types of rubbers and two different positions of the retention wire (distal and proximal). The clinical part of the study included five patients (21–72 years) who were treated using the PRTS. Mean follow-up was 272 days.

Results

The PRTS increased flexion force of the PiP joint. Proximal position of the retention wire increased forces for 30° flexion. Different rubber strengths did neither increase PiP width nor influence flexion forces. In the clinical part of the study total range of motion was 74° and DASH score was 10.1. Pinch grip of the affected digit was 72% of the unaffected side.

Discussion

The PRTS allows for efficient treatment of intraarticular fractures with PiP involvement. Although standardized positioning of the wires is important, proximal position of the retraction only increased forces for 30° flexion.

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Acknowledgments

This work contains parts of Eva Goldberg’s doctoral thesis. The authors would like to thank Juergen Kopp, MD for his help with the statistic analysis. We thank Professor Neuhuber, Department of Anatomy, University Erlangen for providing the cadavers.

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Authors and Affiliations

  1. Department of Plastic and Hand Surgery, University of Erlangen Medical Center, Krankenhausstrasse 12, 91054, Erlangen, Germany

    Ulrich Kneser, Eva Goldberg, Elias Polykandriotis, Bernd Loos, Frank Unglaub, Alexander Bach & Raymund E. Horch

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  1. Ulrich Kneser
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  2. Eva Goldberg
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  3. Elias Polykandriotis
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  4. Bernd Loos
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Correspondence to Ulrich Kneser.

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Kneser, U., Goldberg, E., Polykandriotis, E. et al. Biomechanical and functional analysis of the pins and rubbers tractions system for treatment of proximal interphalangeal joint fracture dislocations. Arch Orthop Trauma Surg 129, 29–37 (2009). https://doi.org/10.1007/s00402-007-0526-1

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  • DOI: https://doi.org/10.1007/s00402-007-0526-1

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