Treatment of intraarticular middle phalanx fractures using the Ligamentotaxor®

We evaluated the outcome of intraarticular middle phalanx fractures after dynamic treatment with the Ligamentotaxor® system.

Ten consecutive patients (seven male, three female; mean age 52 years) with intraarticular middle phalanx fractures were treated with the Ligamentotaxor® between 2009 and 2011. Proximal interphalangeal joint mobility, grip strength and ‘Disabilities of the Arm, Shoulder and Hand’ (DASH) score were evaluated in a 15-month follow-up. The reconstitution of the intraarticular space was measured immediately after trauma, at 6 weeks and at 15 months by radiograph control. The severity of the trauma was classified according to AO.

We found B1 30 %, C1 (Seno I + II) 50 % and C3 (Seno III–V) 20 %. In 60 % of the cases, fractures were localized on the middle base of the fifth digit, in 20 % on the third digit and in 20 % on the index finger. The dynamic treatment lasted 7 weeks; patients were exposed to full workload after 9 weeks. The mean flexion mobility after 15 months reached 73° (range 60–100°), and the extension deficit was 13° (range 0–20°) on average. Grip strength attained 71.3 % (range 60–87 %) of the contralateral side. Initial x-ray after trauma compared to the x-ray after 15 months showed an intraarticular space reconstitution average of 0.5 mm (range 0.1–0.9 mm) anterior–posterior and 0.6 mm (range 0.1–1 mm) lateral. Patients evaluated their outcome with an average of 14.6 points (range 3.3–26.7) using the DASH score.

Good results can be obtained with the Ligamentotaxor®. We recommend it for the dynamic treatment of intraarticular middle phalanx finger fractures. Larger series and long-term results are needed.