Gun Shot Wounds to the proximal interphalangeal joints are associated with considerable morbidity. As the joints are destructed with soft tissue defects, reconstruction of these joints are challenging. Long term problems include stiffness, lack of function and chronic pain. This study looks at the long-term results of management of these injuries using external fixator or k-wire fixation.

Over a four year period, twenty patients underwent application of external fixator for gun shot wounds of the proximal interphalangeal joint with conservative management of the soft tissue defects. We also treated twenty-eight patients with gun shot wounds to interphalangeal joints with k-wire fixation. Post-operatives care of these patients were similar with delayed nerve repair and fixation device being left in until the bone is healed radiologically. All fingers survived with external fixator in place for upto ten weeks (average 7 weeks).

The total active movements of the finger assessed in all patients, movements at the proximal interphalangeal joint, distance of fingertip to palm and grip strength. Functional capacity evaluation was carried out to determine the functional disability.

The patients who underwent application of external fixator to keep the joint in place did better than the patients with k-wire fixation. The total range of movements of the finger was better (12 degrees) and had better grip strength. In conclusion use of external fixator seems to provide better result in salvaging proximal interphalangeal joints.