Functional outcome of mini external fixator in hand injuries: an observational study in a tertiary care hospital

Authors

  • Saravanakumar P. Department Of Orthopaedics, Karpaga Vinayaga Institute of Medical Sciences and Research Center, Madhuranthagam, Tamil Nadu, India
  • Arun Kumar B. Department Of Orthopaedics, Karpaga Vinayaga Institute of Medical Sciences and Research Center, Madhuranthagam, Tamil Nadu, India
  • Kanchan N. Department Of Orthopaedics, Karpaga Vinayaga Institute of Medical Sciences and Research Center, Madhuranthagam, Tamil Nadu, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20241115

Keywords:

Hand fractures, Mini external fixator, Metacarpal fractures, Palangeal fractures, Ortho fix

Abstract

Background: Metacarpal and phalangeal fractures are one of the common fractures of the upper extremity that account for about 10% of total body fractures. The distal parts of the hand are the most common parts to be injured. Outcome is also influenced by other factors such as patient’s age, occupation, socio economic status, systemic illness, surgeon’s skill and the patient’s compliance.

Methods: We are doing an observational study with 40 patients included according to the inclusion and exclusion criteria for a period of six months with age group between 20 and 60 years. We use mini external fixators with JESS clamps, 1.8 mm threaded pins and k wires. Patients were followed up periodically with required radiograph for the union of the fracture.

Results: Out 40 patients, most of the patients were between the age of 21 to 40 years with male preponderance, open fractures were more when compared with closed fractures. Functional outcome was excellent and good on the higher side which was analysed with Strickland score. Radiological union were also in greater side with 17.5% of them with delayed union.

Conclusions: Simple surgical technique will minimize complications and an aggressive rehabilitation will ensure best result. In general, mini external fixator is a good treatment for management of fractures with best functional outcome.   

References

Sehgal A, Gupta P, Mishra M, Sethi C, Kumar R. Evaluation of the role of Dr Joshi’s external fixator in management of complex and compound mutilating injuries of hands and forearm. J Evolution Med Dental Sci. 2013;2(12):1909-33.

Ugwonali OFC. Mini External Fixation in the Hand. Techniques in Hand and Upper Extremity Sur. 2006;10(3):187-96.

Dailiana Z, Agorastakis D, Varitimidis S, Bargiotas K, Roidis N, Malizos KN. Use of a Mini-External Fixator for the Treatment of Hand Fractures. J Hand Surg Am. 2009;34(4):630-6.

Al Saeed AAA, Al Rahman AKI, El Sadek AM, Wahab AMA. Mini External Fixator for Management of Fracture Metacarpals and Phalanges of the Hand. Egypt J Hospital Med. 2020;81(4):17-85-8.

Margic K. External fixation of closed metacarpal and phalangeal fractures of digits. A prospective study of one hundred consecutive patients. Bri Society Surg Hand. 2006;31(1):30-40.

El-Shaer AF, Shams El-Deen AF, El-Deen Abu Hussein AS, Neenaa HA. Results of management of recent fractures of phalanges of the hand by a mini external fixator. Menoufia Med J. 2015;28(4):965.

Venkatesh V, Maruti CV. Functional outcome of mini- external fixator for hand in a rural tertiary care hospital. Int J Orthopaed Sci. 2020;6(3):49-53.

De Jonge JJ, Kingma J, Van Der Lei B. Fractures of the metacarpals. A retrospective analysis of incidence and Aetiology and a review of the English-language literature. Injury. 1994;25:365-9.

Swanson AB. Fractures involving the digits of the hand. Orthop Clin North Am. 1970;1:261-74.

Stern PJ. Management of fractures of the hand over the last 25 years. J Hand Surg [Am]. 2000;25:817-23.

Libberecht K, Lafaire C, Van Hee R. Evaluation and Functional Assessment of Flexor Tendon Repair in the Hand. Acta Chir Belg. 2006;106:560-65.

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

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

Downloads

Published

2024-04-29

Issue

Section

Original Research Articles