Prospective randomized study comparing closed reduction with transarticular K-wire fixation (n=8) versus ORIF with lag screws (n=6) or cerclage wire (n=5) for dorsal PIP fracture-dislocations, with mean 7-year follow-up using validated patient-reported outcomes and objective range-of-motion measures.
When you see a dorsal PIP fracture-dislocation, closed reduction and transarticular K-wire fixation is a defensible first-line option — it matches or outperforms ORIF on functional and patient-reported outcomes while getting patients back to work faster and avoiding the sensory complications and stiffness associated with open dissection.
Better intraoperative radiographs after cerclage wire fixation do not translate to better fingers: prioritize arc of motion and soft-tissue preservation over radiographic perfection.
Prospective randomized study comparing closed reduction with transarticular K-wire fixation (n=8) versus ORIF with lag screws (n=6) or cerclage wire (n=5) for dorsal PIP fracture-dislocations, with mean 7-year follow-up using validated patient-reported outcomes and objective range-of-motion measures.
When you see a dorsal PIP fracture-dislocation, closed reduction and transarticular K-wire fixation is a defensible first-line option — it matches or outperforms ORIF on functional and patient-reported outcomes while getting patients back to work faster and avoiding the sensory complications and stiffness associated with open dissection.
Better intraoperative radiographs after cerclage wire fixation do not translate to better fingers: prioritize arc of motion and soft-tissue preservation over radiographic perfection.