Hand Unit, Orthopaedic Department, Geneva University Hospital, Rue Gabrielle-Perret Gentil 4, 1211 Geneva, Switzerland.
Department of Hand Surgery, Beijing Jishuitan Hospital, 4th Medical College of Peking University, 31 Xinjiekou East Street, 100035, Beijing, China.
J Hand Surg Asian Pac Vol. 2022 Apr;27(2):359-365. doi: 10.1142/S2424835522500242. Epub 2022 Mar 31.
Fracture dislocations of the proximal interphalangeal joint (PIPJ) are challenging injuries and a dynamic external fixator frame is often used. We devised a dynamic external fixator device called the Gexfinger that allows greater control of the degree of traction. The aim of this study is to report the mid-term outcomes of this device. This is a retrospective study of patients with fracture dislocation of the PIPJ who were treated with the Gexfinger over a 3-year period. Clinical data with regard to the patient, the injury, treatment and period of follow-up were recorded. The outcome measures included time to return to work, arc of motion at the interphalangeal joints, grip strength, visual analogue score (VAS) for pain, patient satisfaction and complications. We studied 26 patients (17 men and 9 women) with an average age of 38 years. The average articular surface involvement was 56%. The mean period between injury and surgery was 6 days and the frames were maintained for 5.5 weeks on average. The mean follow-up period was 8.5 weeks. All patients returned to work at an average of 7 weeks. The mean arc of motion at the PIPJ and distal interphalangeal joint (DIPJ) were 82° and 65°, respectively and the mean grip strength was 83% of the contralateral side. 22 patients reported no pain at the final follow-up. Fifteen patients were very satisfied, 8 satisfied and 3 unsatisfied. Two patients had stiffness of the PIPJ. The mid-term outcomes of the Gexfinger are similar to other methods of dynamic traction described in literature. It is modular, easy to assemble and allows a greater control of the degree of traction. In combination with additional screws and/or K-wires, it has allowed us to treat a wide spectrum of PIPJ fracture dislocations with good outcomes. Level IV (Therapeutic).
近节指间关节（PIPJ）骨折脱位是具有挑战性的损伤，通常使用动态外固定架。我们设计了一种称为 Gexfinger 的动态外固定器装置，它可以更好地控制牵引程度。本研究旨在报告该装置的中期结果。 这是一项回顾性研究，纳入了 3 年内接受 Gexfinger 治疗的 PIPJ 骨折脱位患者。记录了患者、损伤、治疗和随访期的临床数据。评估指标包括恢复工作的时间、指间关节活动度、握力、疼痛视觉模拟评分（VAS）、患者满意度和并发症。 我们研究了 26 名患者（17 名男性和 9 名女性），平均年龄 38 岁。平均关节面受累 56%。受伤和手术之间的平均时间为 6 天，外固定架的平均维持时间为 5.5 周。平均随访时间为 8.5 周。所有患者平均在 7 周时恢复工作。PIPJ 和远节指间关节（DIPJ）的平均活动度分别为 82°和 65°，平均握力为对侧的 83%。22 名患者在最后一次随访时无疼痛。15 名患者非常满意，8 名满意，3 名不满意。2 名患者 PIPJ 僵硬。Gexfinger 的中期结果与文献中描述的其他动态牵引方法相似。它是模块化的，易于组装，可以更好地控制牵引程度。结合附加螺钉和/或 K 线，我们可以用它治疗广泛的 PIPJ 骨折脱位，获得良好的效果。 四级（治疗）。
