Mini External Fixator for Management of Fracture Metacarpals and Phalanges of the Hand

Abstract

Background: Fractures of metacarpals and phalanges are the most common fractures of the upper extremity. Objective: The aim of this study was to assess the functional outcomes of management of metacarpal and phalangeal fractures by mini external fixator. Patients and Methods: This prospective study included a total of 12 patients with fractures of metacarpals and phalanges, attending at Orthopedics and Traumatology Departments, Zagazig and Helwan University Hospitals. This study was conducted between August 2018 and July 2019 and was done to assess the functional outcomes of metacarpal and phalangeal fractures fixed by mini external fixator. Results: In this study there was good union time among studied group with average 8.33±2.1 weeks. One case (8.3%) had pin tract infection and one case (8.3%) had delayed union >12 weeks, malunion founded in 2 cases (16.7%) and stiffness founded in 3 cases (25%). At the end of the follow up period, two patients (16.7 %) sustained malunion deformities, one patient (8.35%) had rotational deformity and in another patient (8.35%) had angular malunion. Regarding active movement score 75% were acceptable results (Excellent and Good) and 25% were not acceptable results (Fair and Poor). There was significant association between acceptability of outcome and deformity, as 66.7% of not accepted result had deformity while no one from accepted outcome had deformity. Conclusion: Use of mini external fixator is an adequate procedure for unstable phalangeal and metacarpal fractures. In cases of open fractures, the mini external fixator allows wound inspection and care and avoidance of hardware application at fracture site.