Clinical outcomes of ligamentotaxis in closed phalangeal fractures: a systematic review

Abstract

Closed proximal interphalangeal (PIP) joint and proximal middle phalanx fractures can result in considerable functional disability for the patient. Treatment by ligamentotaxis using a dynamic external fixation (DEF) device appears to be the most promising of several available surgical techniques, although there is no clear consensus. This systematic review of the clinical outcomes of ligamentotaxis in patients with closed phalangeal fractures includes 14 studies and 272 patients. The grand mean QuickDASH (12) and DASH (8) scores show that DEF provides excellent functional results for closed phalangeal fractures at the PIP joint. The incidence of postoperative complications is low and similar to other commonly used surgical techniques, including closed reduction percutaneous pinning, with infection (6.6%) and early osteoarthritis (5.9%) being the most common. Further research in the form of randomized control trials are required to determine the best method of treatment.

Keywords: Dynamic external fixation; ligamentotaxis; middle phalanx; phalangeal fractures; proximal interphalangeal joint; proximal phalanx.