SIMPLE AND EFFECTIVE METHOD FOR MANAGEMENT OF FRACTURES OF BASE OF 1ST METACARPAL USING LIGAMENTOTAXIS AND MINI EXTERNAL FIXATOR FRAME

Abstract

Background- Fractures of the base of rst metacarpal include intra-articular fractures like Rolando fracture and Benette fracture. The ideal management modality of these fractures remains elusive. Management varies from conservative therapy, k wire xations, external xators to formal open reduction and plate xation. Open reduction and anatomic xation though lucrative, is frought with complications like stiffness, implant failure etc due to excessive dissection and soft tissue stripping that is required. Conservative therapy is usually insufcient to allow the fracture to heal in appropriate position as there are numerous muscle forces acting at the base of rst metacarpal which make maintaining the reduction difcult. K wires allow to keep the fracture reduced but obtaining reduction is not an easy task. Here we describe a minimally invasive technique using mini external xator-JESS(Joshi external stabilization system) which requires minimum soft tissue dissection In this prospective study a total of 8 pati Results- ents were included who underwent fracture xation using mini external xator frame. The average time to union was 4 weeks. None of the patients had iatrogenic injury to supercial branch of radial nerve. All of the patients had excellent post xator frame removal hand function. MethodsA prospective analysis was carried out over 8 months. A total of 8 patients met the inclusion criteria and were operated with mini external xator. Regular follow up was done till 8 weeks. At each postoperative visit patients were evaluated for hand function using Kapandji Score Radiographs were taken at each visit to evaluate for fracture alignment and union. Mini Conclusionexternal xator is a simple, minimally invasive surgical technique with excellent functional outcomes for management of Fractures of rst metacarpal