Dynamic External Fixation Using Suzuki Frame for Intra-articular Middle Phalanx Base Fracture with Dorsal Subluxation: A Case Report.

Abstract

Introduction: Injuries involving the base of the middle phalanx with intra-articular extension and dorsal subluxation are challenging to manage, particularly when joint congruity and motion preservation are critical. This case report demonstrates the use of the Suzuki frame for dynamic external fixation in such a scenario and discusses broader clinical considerations.

Case report: A 37-year-old male sustained an intra-articular middle phalanx base fracture with dorsal subluxation of the left index finger during a cricket injury. Examination showed swelling, tenderness, and a flexion deformity. Radiographs confirmed a comminuted volar lip fracture. Under fluoroscopic guidance, a Suzuki frame was applied using three K-wires and rubber band traction. Advanced imaging was not deemed necessary for acute management. Early active motion was initiated post-operatively, followed by a structured hand therapy protocol. At 6 months, radiological union, >90% range of motion, minimal pain, and return to function were achieved.

Conclusion: The Suzuki frame offers a motion-preserving and cost-effective technique for complex phalangeal injuries. Standardized functional outcome measures, complication tracking, and long-term follow-up are essential to support its broader adoption.