SCIENTIFIC ARTICLE Pins and Rubber Band Traction for Treatment of Comminuted Intra-Articular Fractures in the Hand Ahmet Kiral, MD, H. Yener Erken, MD, Ibrahim Akmaz, MD, Cengiz Yildirim, MD, Kaan Erler, MD Purpose To determine the efficacy of pins and rubber band traction for treatment of commi- nuted intra-articular fractures in the hand. Methods We performed a retrospective study from 1994 to 2013 to evaluate 33 patients in whom pins and rubber band traction was employed. We clinically evaluated the active range of motion of the affected fingers after surgery. Eleven of the 33 fractures were at the proximal interphalangeal joint, 10 at the distal interphalangeal joint, 5 at the thumb interphalangeal joint, and 2 at the metacarpophalangeal joint of the thumb. The remaining 5 patients had complex fracture-dislocation of the proximal interphalangeal joints. Results The mean follow-up period was 24 months. The average active motion of the meta- carpophalangeal joints of the fingers was 91  (range, extension 0  e10  /flexion 85  e90  ), proximal interphalangeal joints was 92  (range, extension/flexion 0  e10  /85  e100  ), and distal interphalangeal joints was 73  (range, extension/flexion 0  e10  /60  e80  ). The overall average of all active motion of the injured fingers except thumbs was 255  (range, 240  e270  ). The average active motion of the of the thumb metacarpophalangeal joint was 56  (range, extension 5  e10  /flexion 50  e55  ), and interphalangeal joint was 74  (range, extension 0  e10  /flexion 75  e80  ). The average of active motion of the injured thumb metacarpal and interphalangeal joints combined was 130  (range, 125  e135  ). Conclusions Pins and rubber band traction is a treatment option for comminuted displaced intra-articular fractures of the digits that offers satisfactory clinical results. (J Hand Surg Am. 2014;39(4):696e705. Copyright Ó 2014 by the American Society for Surgery of the Hand. All rights reserved.) Type of study/level of evidence Therapeutic IV. Key words Pins and rubber band traction, intra-articular fractures, hand. A TECHNIQUE THAT RESTORES THE normal anatomy and permits early active joint motion and tendon gliding is necessary to obtain opti- mal results for treatment of comminuted displaced intra-articular fractures of the digits. 1 Various distal traction systems that combine traction with early motion can be used to reposition the fragments. These systems aim to reduce fracture fragments by liga- mentotaxis while preventing joint stiffness. 2e4 The banjo frame is effective but bulky and uncomfortable to wear. 2,4 Recently, light, straightforward, and ef- fective systems such as the force couple splint, vari- ous dynamic external fixator systems, and the pins and rubber band traction have been reported. 1e3,5e8 Pins and rubber band traction described by Suzuki et al 5 is one of these systems and offers several advantages. The goal of this study was to determine the effi- cacy of pins and rubber band traction that we used for From the Department of Orthopaedic Surgery, Anadolu Medical Center, Kocaeli; and the Department of Orthopaedic Surgery, GATA Haydarpas ¸a Education Hospital, Istanbul, Turkey. Received for publication September 16, 2013; accepted in revised form December 27, 2013. No benefits in any form have been received or will be received related directly or indirectly to the subject of this article. Corresponding author: H. Yener Erken, MD, Department of Orthopaedic Surgery, Anadolu Medical Center, Cumhuriyet Mahallesi 2255 Sokak No. 3 Gebze 41400, Kocaeli, Turkey; e-mail: yenererken@yahoo.com. 0363-5023/14/3904-0013$36.00/0 http://dx.doi.org/10.1016/j.jhsa.2013.12.038 696 r Ó 2014 ASSH r Published by Elsevier, Inc. All rights reserved.