Fracture-dislocation of the middle phalanx at the proximal interphalangeal joint: repair with a simple intradigital traction-fixation device.

Fracture-dislocation of the middle phalanx at the proximal interphalangeal joint is a difficult problem. Open reduction and internal fixation, the panacea for so many unstable fractures, has not been the solution to this injury. During the past three decades, a number of papers have combined old methods with newer concepts, including intradigital traction, "ligamentotaxis," and the beneficial effects of early motion on articular cartilage remodeling. This report describes a simple device, using these new concepts and constructed with available materials, which can be placed on the finger in the office or emergency department, thus avoiding open surgery. Results are compared with other intradigital techniques for treatment of this injury.