Orthofix mini external fixator combined with lever technique for minimally invasive prying reduction and limited internal fixation in the treatment of metacarpal and phalangeal fractures at joint sites

Abstract

Objective To investigate the clinical efficacy of Orthofix mini external fixator combined with lever technique for minimally invasive prying reduction and limited internal fixation in the treatment of metacarpal and phalangeal fractures at joint sites. Methods From October 2014 to June 2017, we applied mini external fixator technique to pull and restore joint alignment, then lever technique for minimally invasive prying reduction to restore articular surface, and limited internal fixation to treat 36 metacarpal and phalangeal fractures at joint sites in 34 cases. Fracture healing and hand function recovery were assessed. Results All the patients obtained short-term follow-up for 6 to 10 months, of which 21 cases obtained long-term follow-up for 10 to 30 months. All the fractures healed after operation. The healing time was 5 to 12 weeks, with an average of 7.3 weeks. According to TAM criteria, the excellent and good rate of short-term follow-up was 82.4%, and the excellent and good rate of long-term follow-up was 90.5%. 5 patients had moderate finger activity during short-term follow-up, of which 2 were reoperated after 10 months and had good long-term follow-up function. One patient was unable to cooperate with functional exercise, and the follow-up showed poor finger activity. Conclusion The method is effective in the treatment of metacarpal and phalangeal fractures at joint sites. This technique is minimally invasive, which does not increase the soft tissue adhesion of joint. The reliable fixation can meet the needs of early functional exercise. The injured hand has good appearance without obvious surgical scar at joint sites and the incidence of hand joint stiffness is low. Key words: Metacarpal bones; Finger phalanges; Fractures,bone; Mini external fixator