Indicated for acute dorsal fracture dislocations of the PIP.
Indicated for the treatment of acute, unstable dorsal fracture dislocations of the proximal interphalangeal (PIP) joint of the fingers in which external fixation as provided by the TurnKey FCS alone is sufficient to obtain and maintain concentric reduction of the fracture dislocation during bone and soft tissue healing
Pin Placement Guide that holds the fracture reduced during bone pin installation and facilitates precise pin insertion
Obtains and maintains joint alignment by a method that permits active ROM exercises
Minimally invasive procedure that requires the percutaneous insertion of only two bone pins
Radiolucent device and pin placement guide that optimizes fracture visualization
Reduction force is easily adjusted
Sold in a complete sterile kit
For the TurnKey FCS to obtain and maintain joint realignment, 50% or more of the dorsal base of the middle phalanx, from the radial to ulnar sides, must be intact.
AP, lateral and both oblique x-rays are necessary pre-op, and during TurnKey FCS installation and adjustment, to confirm an adequate portion of the intact dorsal base of the middle phalanx can be concentrically realigned with the condyles of the head of the proximal phalanx.
The Pin Placement Guide holds the middle phalanx reduced while the pins are inserted.
X-ray translucence of the guide makes it easy to see where the bone pins are being placed. Adjustment knobs for both pins make precise placement easier. In addition, it ensures that the bone pins are inserted perpendicular to each other.
Once the TurnKey FCS is installed, lateral x-rays should confirm that this realignment of the dorsal base of the middle phalanx is maintained during active or passive joint motion. If, during active or passive motion, gliding motion arrests and the dorsal side of the joint “opens like a book”, the sharp palmar edge of the intact dorsal base is digging into and abrading the hyaline cartilage of the head of the proximal phalanx. If this “rocking” motion persists, the potential for gliding motion is lost and this abnormal motion will evolve into traumatic arthritis.
The device’s translating force should create normal alignment of the intact dorsal base of the middle phalanx on the head of the proximal phalanx. Maintenance of this alignment requires capsular ligaments that are competent to assure joint alignment and prevent palmar subluxation of the middle phalanx on the head of the proximal phalanx.
The joint reduction effect of the TurnKey FCS is present throughout a complete range of PIP joint motion. Such motion, while reduced secondary to fracture and soft tissue injury during treatment, should be adequate to facilitate an optimal result for a given injury only if concentric, gliding motion is maintained during healing.
The minimally invasive procedure and the ability to perform ROM exercises during fracture healing helps prevent finger stiffness.
Final ROM after TurnKey FCS on the left small finger. NOTE: The definition of an optimal result depends on the geometry of both the bone and soft tissue injury that accompanies each of these difficult fractures. Please study the anatomic and technical issues carefully before deciding to use the TurnKey FCS.