Pins and Rubber Band Traction for Treatment of Comminuted Intra-Articular Fractures in the Hand

Purpose To determine the efficacy of pins and rubber band traction for treatment of comminuted intra-articular fractures in the hand. Methods We performed a retrospective study from 1994 to 2013 to evaluate 33 patients in whom pins and rubber band traction was employed. We clinically evaluated the active range of motion of the affected fingers after surgery. Eleven of the 33 fractures were at the proximal interphalangeal joint, 10 at the distal interphalangeal joint, 5 at the thumb interphalangeal joint, and 2 at the metacarpophalangeal joint of the thumb. The remaining 5 patients had complex fracture-dislocation of the proximal interphalangeal joints. Results The mean follow-up period was 24 months. The average active motion of the metacarpophalangeal joints of the fingers was 91 degrees (range, extension 0 degrees-10 degrees/flexion 85 degrees-90 degrees), proximal interphalangeal joints was 92 degrees (range, extension/flexion 0 degrees-10 degrees/85 degrees-100 degrees), and distal interphalangeal joints was 73 degrees (range, extension/flexion 0 degrees-10 degrees/60 degrees-80 degrees). The overall average of all active motion of the injured fingers except thumbs was 255 (range, 240 degrees-270 degrees). The average active motion of the of the thumb metacarpophalangeal joint was 56 degrees (range, extension 5 degrees-10 degrees/flexion 50 degrees-55 degrees), and interphalangeal joint was 74 degrees (range, extension 0 degrees-10 degrees/flexion 75 degrees-80 degrees). The average of active motion of the injured thumb metacarpal and interphalangeal joints combined was 130 degrees (range, 125 degrees-135 degrees). Conclusions Pins and rubber band traction is a treatment option for comminuted displaced intra-articular fractures of the digits that offers satisfactory clinical results. (Copyright (C) 2014 by the American Society for Surgery of the Hand. All rights reserved.)