Modified Suzuki Technique With Cable-Ties for Unstable Fracture-Dislocations of the Proximal Interphalangeal Joint

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To the Editor:
Various treatment options have been described for fracture-dislocations of the proximal interphalangeal joint (PIP).1 The ideal treatment should be inexpensive, reproducible, and should permit early motion. The use of ligamentotaxis through distraction has proved to be a valuable tool to obtain and maintain fracture reduction.2–9 Dynamic distraction external fixation for the management of unstable PIP joint fracture-dislocations and pilon injuries is a simple device, made with K-wires and rubber bands. This device is inexpensive, easely reproducible, with low interference with daily activities.
Different K-wire configurations have been published since now.2–9 Some of the described frames are challenging for the surgeon and unwieldy to the patient. Moreover, rubber bands seem to be not always reliable on traction control.
We propose the use of simple plastic cable-ties (Figs. 1,2), worldwide available, as cheap tool to maintain a stable distraction of the K-wire frame. Active mobilization of the PIP joint is not hindered by this tool.
We think this technique is a simple and time-efficient alternative to the dynamic external fixator based on rubber bands. It does rely on a stable and constant distraction force, with the chance to manage the amount of distraction under fluoroscopy.
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