XXXX 's pins and rubber traction for fractures of the base of the middle phalanx.

@entity1 @entity174 @entity9256 @entity158 @entity130 @entity6953
Basal fractures of the middle phalanx are uncommon, but difficult to treat. We have reviewed our first 20 @entity1 using the @entity6953 pins and rubber traction who were treated during an 8.5 year period (June 1998-December 2006) and 18 who were reviewed after 49 (range 17-116) months. All @entity130 were closed fractures of the base of the middle phalanx. Ten @entity1 had a @entity174 and dorsal subluxation of the phalanx, one had a @entity174 of the dorsal lip, and seven had @entity9256 . Median operating time was 33 (18-255) minutes. Thick "vessel loops" were often used for traction, and active movement before the traction was removed after 38 (8-46) days was disappointing. There were two superficial infections and one deep. One proximal interphalangeal (PIP) joint had been treated by arthrodesis and another amputated before review. On a visual analogue scale (VAS) from 0 (best) to 10 (worst), @entity1 at review reported discomfort when wearing the traction as 5.5 (0-10), @entity158 as 0 (0-6), and finger function as 3 (0-6). The median Quick-DASH score (100 = worst) was 2 (0-48) and grip strength 97 (75-118) % of the other hand. Median extension, flexion, and total range of movement of the PIP joint in 16 fingers were -9  , 83  , and 72  , respectively. Our results are no more than adequate. They might have been better if the force of traction had been less by using rubber bands instead of vessel loops, if postoperative follow-up had been more frequent allowing for correction of traction when necessary, and if traction had been discontinued earlier.
