Une simple fixation externe à bas prix pour les fractures luxations de la main

Abstract

Fracture dislocation is one of the most common and challenging problems in hand surgery. Pin fixation is the most common fixation device in the hand but sometimes we need to use external fixators in hand fractures and diseases. Commercial hand external fixators are expensive and sometimes they are not available. Since it has been presented some alternative solutions for this technique to overcome these problems, like Suzuki technique, Pin stabilizing with syringe or orthopedic cement and so on. We introduce a new alternative for this treatment, which is simple, available and with low price. Pi frame can be used as static or dynamic external fixator. From June 2016 to February 2018, 24 patients with hand and finger problems and trauma underwent external fixation stabilizing with Pi frame, including 8 phalangeal fracture, 6 PIP fracture dislocations, 7 metacarpal fracture and 3 congenital diseases. Eighteen cases as static and 6 cases as dynamic fixator. Technique For static external fixator we inserted the 1–1.5 mm pins at proper sites for example perpendicular to fracture lines and bent them to be caught with electric strip terminal block (Venus industrial group, Iran). For dynamic type, the proximal pin inserted parallel to articular surface and in the center of rotation of the adjacent joint. The pin bent 90 degrees and attached to the distal pins with a strip terminal block. We had one patient with delayed union, 6 patients with different degrees of limitation of joint motion. We had not seen any cases with pin tract infection, hyper-sensibility to the frame pin loosening or complaint of the appearances of the device. Fracture dislocation in hand is difficult to manage. Ilizarov and other external fixators has been evolved to overcome this problem but they are expensive and they are not available in some centers. Strip terminal block is a low price device available in all electrical stores. As a temporary external fixator it needs no bio-compatible studies. It is suitable everywhere but specially in area with lower outcomes and economic sanction. Pi mini external fixator is an available, simple with low price device with almost satisfactory results in difficult hand problems.