| Objective: This study was designed to evaluate the three different methods in treatment of comminuted fractures of the middle phalangeal base and the active range of motion comparison after clinical treatment.METHODS: from February 2009 to February 2011 with comminuted fractures at the base of the middle phalanges of fingers in 48 patients with 53 fingers, There were 37 males and 11 females with a mean age of 33 years (range, 15–63 years). The little finger was involved in 7 patients, ring finger in 10, middle finger in 19, and index finger in 17patients.The middle phalangeal base was affected as follows: 30 in crush, 18 in sport or fight. Twenty-one patients who had open reduction and internal fixation with Kirschner-wires and eighteen patients who had traction brace of hand, fourteen patients who had the pins and rubbers traction. Between injury and surgery 3h-6d, an average of 3.5d.Results: All the fractures healed and the mean time is 6～8 weeks. The ORIF mean PIP joint arc of motion was 52.00°±20.70°. There were 5 cases of pain of the PIP joint, 1 case of superficial infection that resolved with antibiotic therapy. The traction brace of hand mean PIP joint arc of motion was 55.24°±18.42°.There were 4 cases of pain of the PIP joint, 1 patient had persistent pain and subsequently had a fusion of the PIP joint. In 3 cases, there was persistent swelling of the DIP joint. The PRTS mean PIP joint arc of motion was71.35°±16.50°,There were 3 cases of pain of the PIP joint, In 2cases, there was persistent swelling of the DIP joint. There was 1 case of superficial pin site infection that resolved with antibiotic therapy.Conclusions: Treatment of comminuted fractures of the middle phalangeal base with the Pins and Rubbers Traction System (PRTS) seems to be an effective treatment. The mean PIP joint arc of motion is better than the other two operation methods,statistically significant by statistical tests. |
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