Poster Presentation New Zealand Association of Plastic Surgeons Annual Scientific Meeting

Variations in Suzuki frame fixation and its indications for proximal interphalangeal joint fractures (1650)

Kathleen Lim 1 , Edwin Morrison 1 , Michael W Findlay 1 , Krishna Rao 1 , Rostam D Farhadieh 1
  1. Plastic, Reconstructive and Hand Surgery, Canberra Hospital, Canberra, ACT, Australia

High energy injuries to the hand sustained in motor vehicle accidents or sports can result in complex comminuted intra-articular fractures of the proximal interphalangeal joint (PIPJ). Suzuki et al proposed a system of pins-and-rubbers dynamic external distraction technique to manage these complex intra-articular fractures.1 Overtime, the ‘Suzuki frame’ has been modified in various ways to provide comfortable and reliable fixation for early PIPJ mobilization while maintaining fracture reduction.

This is a retrospective analysis of ‘Suzuki frame’ fixations in a single center. Types of ‘Suzuki frame’ installed were based on the fracture pattern and PIPJ stability. Patients’ demographics, surgical details, and outcomes were recorded.

A total of 48 patients were included in this study with 49 ‘Suzuki frames’ installed over an eight-year period. 37 (78%) patients were male and had a median (IQR) age of 32 (27-45) years. Three variations of ‘Suzuki frames’ were used: 24 (49%) 2-pin curved frames, 20(41%) 3-pin curved frames, and 5 (10%) 2-pin curved frame with dorsal blocking wire adjunct.

The ‘Suzuki frame’ was removed post-operatively after 41(35-47) days. Patients were followed up for a median of 82 (58-184) days. 15 (31%) patients did not have hand therapy follow-up in the public healthcare system for their final active range of motion to be measured. The remaining 33 (69%) patients achieved active PIPJ flexion of 85 (65-90) degrees, active DIPJ flexion of 55 (28-70) degrees, and TAM of 202 (199-241) degrees. 

‘Suzuki frame’ is a simple, reliable, and reproducible technique which can be modified based on fracture pattern to achieve stable fixation which allows early post-operative active range of motion of the PIPJ.

  1. Suzuki, Y., Matsunaga, T., Sato, S., Yokoi, T., 1994, The pins and rubbers traction system for treatment of comminuted intra-articular fractures and fracture dislocations in the hand, Journal of hand surgery: European volume, vol. 19, no. 1, pp. 98-107.