Department of Plastic Reconstructive and Aesthetic Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Plastic, Reconstructive and Aesthetic Surgery, Güven Hospital, Ankara, Turkey.
J Hand Surg Asian Pac Vol. 2024 Jun;29(3):211-216. doi: 10.1142/S242483552450022X. Epub 2024 May 10.
The pins and rubber traction system (PRTS) has proven effective in managing intra-articular fractures of the proximal interphalangeal joint. However, there is scant evidence in the literature regarding its efficacy in treating distal interphalangeal joint (DIPJ). This study aims to investigate the outcomes of PRTS in the treatment of comminuted intra-articular fractures of the DIPJ. We conducted a retrospective review of patients with comminuted intra-articular fractures of the DIPJ treated with PRTS between 2017 and 2021. At the final follow-up, we measured and compared the active range of motion (ROM) in both affected and non-injured contralateral fingers. The subjective evaluation utilised the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) questionnaire and the Visual Analogue Scale (VAS). Ten patients with a mean follow-up of 13.2 months (range: 12-17) were included in the study. Fracture locations included the base of the distal phalanx in two patients, the condyle of the middle phalanx in seven and both in one patient. At the final follow-up, the average VAS score was 0.5 (range: 0-2). The average active motion of the DIPJ was 61° (range: 50°-70°) for the injured side and 76° (range: 75°-80°) for the opposite side. The mean range of DIPJ movement was 80% (range: 68%-87%) of the non-injured side. Extension deficits were observed in five patients, with a median deficit value of 10° (range: 5°-10°). The average Quick-DASH score was 2.9 (range: 0-11.3). The PRTS can be considered as an effective surgical technique in managing comminuted intra-articular fractures of the DIPJ. Level IV (Therapeutic).
克氏针和橡胶牵引系统（PRTS）已被证明在治疗近节指间关节的关节内骨折方面是有效的。然而，文献中关于其治疗远节指间关节（DIPJ）的疗效的证据很少。本研究旨在探讨 PRTS 在治疗 DIPJ 粉碎性关节内骨折中的疗效。
我们对 2017 年至 2021 年间接受 PRTS 治疗的 DIPJ 粉碎性关节内骨折患者进行了回顾性研究。在最终随访时，我们测量并比较了患指和健侧未受伤手指的主动活动范围（ROM）。主观评估采用了简易上肢功能测试（Quick-DASH）问卷和视觉模拟评分（VAS）。
本研究共纳入 10 例患者，平均随访 13.2 个月（范围：12-17 个月）。骨折部位包括 2 例远节指骨基底部、7 例中节指骨骨干部和 1 例同时累及上述两部位。最终随访时，VAS 评分为 0.5（范围：0-2）。DIPJ 的主动活动度平均为 61°（范围：50°-70°），患侧为 76°（范围：75°-80°），健侧为 80%（范围：68%-87%）。5 例患者存在伸指受限，中位数为 10°（范围：5°-10°）。平均 Quick-DASH 评分为 2.9（范围：0-11.3）。
PRTS 可被视为治疗 DIPJ 粉碎性关节内骨折的有效手术技术。
等级 IV（治疗性）。
