Ligamentotaxis-Based Dynamic External Fixation for Comminuted Intra-articular Fractures of the Proximal Phalanx Base of the Thumb: A Report of Two Cases.
- 1Department of Trauma and Orthopedic, Arm and Hand Microsurgery Unit, Medcare Orthopaedic and Spine Hospital, Dubai, ARE.
Abstract
Complex intra-articular fractures of the proximal phalanx of the thumb present significant management challenges due to comminution, displacement, and the thumb's essential functional role. Traditional fixation techniques may risk soft-tissue injury or fail to provide stable conditions for early mobilization. Dynamic external fixation (DEF) using ligamentotaxis offers a minimally invasive alternative, though its use in comminuted proximal phalanx fractures of the thumb remains sparsely reported. This report describes two male patients with displaced, comminuted intra-articular fractures of the base of the proximal phalanx, resulting from a crush injury and a fall from height. Computed tomography imaging confirmed substantial articular displacement in both cases. Both patients underwent mini-open reduction under fluoroscopic guidance, followed by placement of a ligamentotaxis-based DEF. This technique restored articular congruity while minimizing soft-tissue disruption. Both patients recovered uneventfully with preserved neurovascular function, maintained fracture reduction, near-normal range of motion, grip strength recovery of 90-95%, full thumb opposition, and return to work within four to five weeks. These cases support ligamentotaxis-based DEF as a feasible option for comminuted intra-articular fractures of the proximal phalanx base of the thumb.
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BibTeX
@article{ali2026ligamentotaxisbased,
title = {{Ligamentotaxis-Based Dynamic External Fixation for Comminuted Intra-articular Fractures of the Proximal Phalanx Base of the Thumb: A Report of Two Cases.}},
author = {Mohammad A Ali},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116681},
url = {https://europepmc.org/article/MED/42923452},
note = {CC BY},
}
RIS
TY - JOUR
TI - Ligamentotaxis-Based Dynamic External Fixation for Comminuted Intra-articular Fractures of the Proximal Phalanx Base of the Thumb: A Report of Two Cases.
AU - Mohammad A Ali
PY - 2026
DA - 2026/09/21
JO - Cureus
DO - 10.7759/cureus.116681
UR - https://europepmc.org/article/MED/42923452
AB - Complex intra-articular fractures of the proximal phalanx of the thumb present significant management challenges due to comminution, displacement, and the thumb's essential functional role. Traditional fixation techniques may risk soft-tissue injury or fail to provide stable conditions for early mobilization. Dynamic external fixation (DEF) using ligamentotaxis offers a minimally invasive alternative, though its use in comminuted proximal phalanx fractures of the thumb remains sparsely reported. This report describes two male patients with displaced, comminuted intra-articular fractures of the base of the proximal phalanx, resulting from a crush injury and a fall from height. Computed tomography imaging confirmed substantial articular displacement in both cases. Both patients underwent mini-open reduction under fluoroscopic guidance, followed by placement of a ligamentotaxis-based DEF. This technique restored articular congruity while minimizing soft-tissue disruption. Both patients recovered uneventfully with preserved neurovascular function, maintained fracture reduction, near-normal range of motion, grip strength recovery of 90-95%, full thumb opposition, and return to work within four to five weeks. These cases support ligamentotaxis-based DEF as a feasible option for comminuted intra-articular fractures of the proximal phalanx base of the thumb.
SN - 2168-8184
ER -