Lessons learned from the management of complex intra-articular fractures at the base of the middle phalanges of fingers.

The use of dynamic traction splintage is established in the treatment of complex intra-articular phalangeal fractures. Several different systems have been used and we report our experience with one of these, the Pins and Rubber Traction System. A cohort of 14 patients with complex intra-articular fractures at the base of the middle phalanges of the fingers were treated and assessed prospectively over a 2.5-year period (mean, 20 months; range, 7-28 months). The mean active range of motion regained, at the proximal interphalangeal joint, was 74 degrees (range, 0-100 degrees ). The mean total active motion of the injured digit was 196 degrees (range, 40-275 degrees ). Refinements in the regime are suggested as a result of this investigation.