Ligamentotaxis-Based Dynamic External Fixation for Comminuted Intra-articular Fractures of the Proximal Phalanx Base of the Thumb: A Report of Two Cases
Year: 2026
Type: article
Study design: Case Report
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.
Source: Cureus
Author: Mohammad A Ali
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7213986798