Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 4 Issue 9

Management of Fractures of Metacarpals and Phalanges of Hand with Mini External Fixator

Shivaraj B1, Shiva Kumar Bingi2, Parvez Ahmad Ganie3, Aquib Suheil Pasha4 and Madhan Jeyaraman3*

1Department of Orthopaedics, Fortis Hospital, Bengaluru, Karnataka, India
2Department of Orthopaedics, Relief Hospital, Warangal, Telangana, India
3Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
4Department of Orthopaedics, JJM Medical College, Davangere, Karnataka, India

*Corresponding Author: Madhan Jeyaraman, Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India.

Received: July 27, 2021; Published: August 12, 2021

Abstract

Introduction: Metacarpal and phalangeal fractures are more common injuries in hand, either closed or open. These injuries are encountered every day. Most of the fractures are treated conservatively, but for unstable fractures, open fractures, comminuted fractures operative treatment is indicated. This study was undertaken to evaluate the functional outcome of closed or open metacarpal and phalangeal fractures treated with a mini-external fixator.

Materials and Methods: From July 2016 to June 2019, a total of 40 cases of metacarpal and phalangeal fractures of the hand were treated with a mini-external fixator. All patients were screened using inclusion and exclusion criteria. Follow up was done till 12 months to evaluate the fracture union and range of movements by DASH score.

Results: The mean soft tissue healing was 2.56 weeks. The mean fracture healing was 14.45 weeks. The results were found excellent in 55%, good in 22.5% cases, fair in 15% cases, whereas poor results were seen in 7.5% of fractures.

Conclusion: External fixation is an adequate alternative treatment for unstable phalangeal and metacarpal fractures which are open or accompanied by severe soft-tissue injuries.

Keywords: Mini-External Fixator; Metacarpal; Phalanx; DASH Score

References

  1. Moore A and Varacallo M. “Metacarpal Hand Fracture”. In: StatPearls. Stat Pearls Publishing (2021).
  2. Kamath JB., et al. “Current concepts in managing fractures of metacarpal and phalanges”. Indian Journal of Plastic Surgery 2 (2011): 203-211.
  3. Dean BJF and Little C. “Fractures of the metacarpals and phalanges”. Orthopaedics and Trauma 1 (2011): 43-56.
  4. AlMugren TS., et al. “Epidemiology and patterns of the hand and distal forearm fractures at King Abdul-Aziz Medical City, Riyadh, KSA”. Journal of Taibah University Medical Sciences 1 (2016): 86-90.
  5. Bakki SS., et al. “Stabilisation of metacarpal and phalangeal fractures with JESS fixation”. Journal of Evidence Based Medicine and Health Care 12 (2017): 661-668.
  6. Singh J., et al. “Outcome of closed proximal phalangeal fractures of the hand”. The Indian Journal of Orthopaedics 5 (2011): 432-438.
  7. Zyluk A and Budzyński T. “Treatment of metacarpal and phalangeal fractures-a review”. Chirurgia Narządów Ruchu i Ortopedia Polska 4 (2006): 299-308.
  8. Wahl EP and Richard MJ. “Management of Metacarpal and Phalangeal Fractures in the Athlete”. Clinic in Sports Medicine 2 (2020): 401-422.
  9. Giddins GEB. “The non-operative management of hand fractures”. The Journal of Hand Surgery European1 (2015): 33-41.
  10. Kollitz KM., et al. “Metacarpal fractures: treatment and complications”. Hand1 (2014): 16-23.
  11. Margić K. “External fixation of closed metacarpal and phalangeal fractures of digits. A prospective study of one hundred consecutive patients”. The Journal of Hand Surgery: British1 (2006): 30-40.
  12. Shehadi SI. “External fixation of metacarpal and phalangeal fractures”. Journal of Hand Surgery3 (1991): 544-550.
  13. McDaniel DJ and Rehman UH. “Phalanx Fractures of the Hand”. In: StatPearls. StatPearls Publishing (2021).
  14. Gupta SV., et al. “Management of fractures of metacarpals and phalanges of hand with UMEX (universal mini external fixator)”. International Journal of Orthopaedics Sciences4 (2015): 965-970.
  15. Jenkin E. “Treatment of intra-articular metacarpal and phalangeal fractures with an external fixation minidevice”. Handchirurgie, Mikrochirurgie, Plastische Chirurgie 3 (1983): 198-203.
  16. Parsons SW., et al. “External fixation of unstable metacarpal and phalangeal fractures”. The Journal of Hand Surgery: British 2 (1992): 151-155.
  17. Mullett JH., et al. “Use of the “S” Quattro dynamic external fixator in the treatment of difficult hand fractures”. The Journal of Hand Surgery: British 3 (1999): 350-354.
  18. Kontakis GM., et al. “Rolando’s fracture treated by closed reduction and external fixation”. Archives of Orthopaedic and Trauma Surgery 1-2 (1998): 84-85.
  19. Fricker R., et al. “[AO external mini-fixateur for the hand bones. Surgical technique and initial experiences]”. Chirurg 7 (1996): 760-763.
  20. Inanami H., et al. “Dynamic external finger fixator for fracture dislocation of the proximal interphalangeal joint”. Journal of Hand Surgery American1 (1993): 160-164.
  21. Johnson D., et al. “Dynamic external fixation for complex intraarticular phalangeal fractures”. The Journal of Hand Surgery: British1 (2004): 76-81.
  22. Li W., et al. “Management of intra-articular fracture of the fingers via mini external fixator combined with limited internal fixation”. Chinese Medical Journal21 (2009): 2616-2619.
  23. El-Shaer. “Results of management of recent fractures of phalanges of the hand by a mini external fixator”. Menoufi a Medical Journal4 (2015): 965-970.
  24. Yaseen G., et al. “Results of mini external fixator in metacarpal and phalangeal fractures”. Pakistan Armed Forces Medical Journal5 (2016): 715-719.
  25. Gupta R., et al. “Evaluation of surgical stabilization of metacarpal and phalangeal fractures of hand”. The Indian Journal of Orthopaedics3 (2007): 224-229.
  26. Kapur B., et al. “An Alternative Technique for External Fixation of Traumatic Intra-articular Fractures of Proximal and Middle Phalanx”. Techniques in Hand and Upper Extremity Surgery4 (2015): 163-167.
  27. Drenth DJ and Klasen HJ. “External fixation for phalangeal and metacarpal fractures”. The Journal of Bone and Joint Surgery British2 (1998): 227-230.

Citation

Citation: Madhan Jeyaraman., et al. “Management of Fractures of Metacarpals and Phalanges of Hand with Mini External Fixator".Acta Scientific Orthopaedics 4.9 (2021): 34-39.

Copyright

Copyright: © 2021 Madhan Jeyaraman., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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