External fixation device for closed treatment of metacarpal fractures

Abstract

For the treatment of closed metacarpal fractures bones designed external fixation devices, which allow closed reduction and fixation of fracture frafments. But rather complicated structure and large size limit their use. Objective: to present external fixa­tion device and treatment technology of closed displaced meta­carpal fracture. Methods: treatment with the proposed external fixation device conducted in 21 patients (2 women and 19 men, age 15 to 46 years) with closed displaced metacarpal fractures. II metacarpal bone fracture was found in 4 patients, IV — 9, V — 7, while IV–V — in 1. All patients previously underwent un­successful attempts of closed reposition. Results: the apparatus consists of a basic and mobile pin-holders, threaded distractor and two connecting rods. Reduction device is a separate pin-holder with holes for directing and rods, clamping screws, pene­trating smooth cylindrical hole in which freely passes distractor. After 2 holes in the base of pin-holder the proximal metacarpal bone fragment inserted two threaded rod and the proximal pha­lanx through hole of reduction pin-holder — usually one. To car­ry out distraction by 2–3 mm per day. Due to ligamentotaxis fracture is selfreduced. If the reduction achieved, the 2–3 hole in a moving pin-lock distractor of distal metacarpal bone adminis­tered 2–3 pins perform moderate compression and radiological control. In 14 cases achieved anatomic reposition of fragments. In 6 patients observed acceptable position. All patients in terms of fractures healed 3–5 weeks. Conclusions: the proposed exter­nal fixation device allows closed reduction and fractures fixa­tion of metacarpal bone of any kind of displacement.