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PIP Joint External Fixation

 PIP joint pilone fracture xray  29y/o RHD Male sustained right small finger PIP Pilon Fracture when the tip of the finger was struck with softball. A/P and lateral injury films shown.
PIP joint external fixation technique Treated with dynamic PIP joint external fixation (Badia A, J Hand Surg 2005;30A:154)
  1. 0.045in K-wire placed tranversely through center of the head of the prox phalanx
  2. 0.045in K-wire placed through center of the head of the middle phalanx
  3. Proximal K-wire is bent 90 degrees to be parallel to middle phalanx
  4. End of proximal phalanx k-wire is bent >90 degrees dorsally and again >90 degrees volarly to make S configuration at tip
  5. Traction applied and distal K-wire is engaged and bent 90 degrees to prevent disengagement

For dynamic fixator see Ruland RT, J Hand Surg 2008;33:19.

PIP joint external fixation xray  
PIP Pilon external fixation xray  
PIP fracture xray Lateral view s/p ex fix removal. Patient had final painless ROM of 10-75 degrees.