Research Articles

A Dynamic Approach to Managing Unstable Proximal Interphalangeal Joint Fractures: The Suzuki Frame

Abstract

Background: This study aimed to investigate the clinical and radiological outcomes in unstable proximal interphalangeal joint (PIPJ) fracture-dislocations using the Suzuki frame.
Methods: 21 patients (mean age: 33.14 years) with unstable fractures of the PIPJ were treated with a Suzuki frame. The mean interval between injury and surgery was 6.14 days. Early active range of motion (ROM) of all fingers was encouraged immediately after surgery. Patients were followed closely for the first two weeks, and clinical and radiological outcomes were measured at the final follow-up.

Results: Frames were removed at 6 weeks, with all fractures achieving union and stable, congruent PIPJ. One patient developed a pin-tract infection, resolved with antibiotics. Mean PIPJ ROM was -7.85° extension to 75.7° flexion; distal interphalangeal joint (DIPJ) ROM was -8.5° extension to 40.0° flexion. Mean grip strength was 13.5 kg, and mean visual analogue scale (VAS) pain score was 0.6. Early surgery (< 7 days) was associated with better DIPJ flexion (P = 0.008) and lower pain scores (P = 0.029).

Conclusion: The Suzuki frame is a convenient, inexpensive, and effective system to manage difficult unstable PIPJ fracture- dislocations.

1. Caggiano NM, Harper CM, Rozental TD. Management of proximal interphalangeal joint fracture dislocations. Hand Clin. 2018;34(2):149-65. doi: 10.1016/j.hcl.2017.12.005. [PubMed: 29625635].
2. Gianakos A, Yingling J, Athens CM, Barra AE, Capo JT. Treatment for acute proximal interphalangeal joint fractures and fracture-dislocations: A systematic review of the literature. J Hand Microsurg. 2020;12(Suppl 1):S9-S15. doi: 10.1055/s-0040-1713323. [PubMed: 33335365]. [PubMed Central: PMC7735550].
3. Kiefhaber TR, Stern PJ. Fracture dislocations of the proximal interphalangeal joint. J Hand Surg Am. 1998;23(3):368-80. doi: 10.1016/s0363-5023(05)80454-x. [PubMed: 9620177].
4. Suzuki Y, Matsunaga T, Sato S, Yokoi T. The pins and rubbers traction system for treatment of comminuted intraarticular fractures and fracture-dislocations in the hand. J Hand Surg Br. 1994;19(1):98-107. doi: 10.1016/0266-7681(94)90059-0. [PubMed: 8169490].
5. Deshmukh SC, Kumar D, Mathur K, Thomas B. Complex fracture-dislocation of the proximal interphalangeal joint of the hand. Results of a modified pins and rubbers traction system. J Bone Joint Surg Br. 2004;86(3):406-12. doi: 10.1302/0301-620x.86b3.14350. [PubMed: 15125130].
6. Slade JF, Baxamusa TH, Wolfe S. External fixation of proximal interphalangeal joint fracture-dislocations. Atlas Hand Clin. 2000;5:1-29.
7. De Smet L, Boone P. Treatment of fracture-dislocation of the proximal interphalangeal joint using the Suzuki external fixator. J Orthop Trauma. 2002;16(9):668-71. doi: 10.1097/00005131-200210000-00009. [PubMed: 12368648].
8. Ruland RT, Hogan CJ, Cannon DL, Slade JF. Use of dynamic distraction external fixation for unstable fracture-dislocations of the proximal interphalangeal joint. J Hand Surg Am. 2008;33(1):19-25. doi: 10.1016/j.jhsa.2007.07.018. [PubMed: 18261660].
9. Wang HZ, Zhao JY, Zhang ZS. A novel dynamic distraction external fixator for proximal interphalangeal joint fracture dislocation. J Int Med Res. 2019;47(4):1628-35. doi: 10.1177/0300060519826821. [PubMed: 30747021]. [PubMed Central: PMC6460624].
10. Wang C, Li C. Comparative analysis of dynamic external fixation, static external fixation, and internal fixation in interphalangeal joint fractures: outcomes, complications, and clinical implications. J Orthop Surg Res. 2025;20(1):265. doi: 10.1186/s13018-025-05644-z. [PubMed: 40069767]. [PubMed Central: PMC11899099].
Files
IssueVol 12 No 1 (2026) QRcode
SectionResearch Articles
Keywords
Kirschner Wire Fracture Fixation Joint Dislocations Range of Motion

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Rashid R, Beigh I. A Dynamic Approach to Managing Unstable Proximal Interphalangeal Joint Fractures: The Suzuki Frame. J Orthop Spine Trauma. 2026;12(1):19-22.