Pilon fracture of the proximal interphalangeal joint: Use of a combination of fixation techniques

Abstract

Proximal interphalangeal joint pilon fractures are unstable injuries with the potential sequelae of joint pain and stiffness. The goals for surgical treatment of these injuries are to create a stable, congruent joint with fixation that allows early motion as the fracture heals. This chapter presents the case of a proximal interphalangeal joint pilon fracture that was treated with dynamic external fixation, limited open reduction and internal fixation, and extension block pinning. By combining traction with direct reduction and fixation, satisfactory reduction of the joint was achieved, and the result was functional range of motion of the joint with minimal discomfort. This case suggests that surgeons become familiar with multiple treatment techniques for these injuries and be flexible in combining these techniques as required for individual fracture patterns.