An assessment of functional outcome and management of metacarpal and phalangeal fractures of hand with universal mini external fixator

Authors

  • Addanki Vijayanand Department of Orthopaedics, Narayana Medical College, Nellore, Andhra Pradesh, India
  • Alam Penchalaih Department of Orthopaedics, Narayana Medical College, Nellore, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20202031

Keywords:

Metacarpal fractures, UMEX, Duncan’s criteria, Swnason’s criteria

Abstract

Background: Trauma to the hand is quite common and may result in fractures of the bones. Hand fractures can be complicated by deformity from no treatment, stiffness from over treatment and both deformity and stiffness from poor treatment. To evaluate the outcome of metacarpal and phalangeal fractures managed with UMEX (universal mini external fixator) in order to assess their usefulness in different fracture types and to make recommendations regarding potential applications.

Methods: A one-year prospective study at Narayana medical college was conducted and 50 cases were included following the inclusion criteria. All the cases were evaluated and assessment of injury was done by Swnason’s criteria. UMEX application was done on all cases and follow up was done and functional assessment done following Duncan’s criteria.

Results: Male predominance was observed, 21-40 years was common age group (30%) and RTA was common cause (72%). 57 total fractures with 66.7% in right hand, 45.62% were metacarpals, 36.84% proximal phalanx and 80% were shaft fractures. 61.4% of cases had radiological union within 8-12 weeks and partial stiffness was the commonest complication (52.17%). As per the Duncan’s criteria, 44% had good outcome, 40% had excellent outcome, 10% had fair and 6% had poor outcome.

Conclusions: UMEX is an adequate treatment modality for multiple, intra articular and open fractures. Understanding the basic principles and correct application methodology is absolutely essential for optimal usage of the equipment. It’s a useful tool in management of small fractures of the hand.

 

Author Biographies

Addanki Vijayanand, Department of Orthopaedics, Narayana Medical College, Nellore, Andhra Pradesh, India

Associate Professor 

Department of orthopaedics

Alam Penchalaih, Department of Orthopaedics, Narayana Medical College, Nellore, Andhra Pradesh, India

Assistant Professor 

Department of orthopaedics

References

Sheshadri SI. External fixation of metacarpal and phalangeal fractures. J Hand Surg. 1991;16(3):544-50.

Gupta R, Singh R, Siwach R. Evaluation of surgical stabilization of metacarpal and phalangeal fractures of hand. Indian J Orthop. 2007;41(3):224-9.

Hove LM. Fractures of the Hand. Scandinavian J Plastic Reconstructive Surg Hand Surg. 1993;27(4):317-9.

Richard W, Duncan MD. Open hand fractures: An analysis of the recovery of active motion and of complications. J Hand Surg. 1993;18(3):387-94.

Swanson, Todd V. Open hand fractures: Prognosis and classification. J Hand Surg. 1976;16(1):101-7.

Kamath JB, Harshvardhan, Naik DM, Bansal A. Current concepts in managing fractures of metacarpal and phalangess. Indian J Plast Surg. 2011;44(2):203-11.

Basar H, Basar B, Basci O. Comparison of treatment of oblique and spiral metacarpal and phalangeal fractures with mini plate plus screw or screw only. Arch Orthop Trauma Surg. 2015;135:499-504.

Soni A, Gulati A, Bassi JL. Outcome of closed ipsilateral metacarpal fractures treated with mini fragment plates and screws: a prospective study. J Orthopaed Traumatol. 2012;1(13):29-33.

Freeland AE, Orbay JL. Extraarticular hand fractures in adult. Clin Orthop Relat Res. 2006;445:133-45.

Xu J, Zhang C. Mini-plate versus Kirschner wire internal fixation for treatment of metacarpal and phalangeal fractures in Chinese Han population: a meta-analysis. J Orthop Surg Res. 2014;9(24):105-17.

Strickland JW, Steichen JB, Kleinman WB, Hasting HJ, Flynn N. Phalangeal fractures: factors influencing digital performance. Orthop Rev. 1982;11:39-50.

Mohammed R, Farook MZ, Newman K. Percutaneous elastic intramedullary nailing of metacarpal fractures: surgical technique and clinical results study. J Orthop Surg Res. 2011;6(1):37.

Blazar PE, Leven D. Intramedullary nail fixation for metacarpal fractures. Hand Clin. 2010;26(3):3215.

Downloads

Published

2020-06-23

Issue

Section

Original Research Articles