Simple low cost static external fixators for phalangeal fractures of hand

Abstract

Introduction: Fractures of phalanges are the most common fractures with Incidence of 2.9% every year. They are more common in the young to middle-aged males. The phalangeal fractures are usually considered as simple injuries. Such kind of injuries may results into deformity, if not addressed properly at beginning. Phalangeal fractures with unacceptable angulation and rotations in any plane require operative fixation. There are numbers of external fixators which are versatile in the designs but needs thorough expertise to use. We describe a simple, low cost, 'easy to construct and easy to use' external fixator which can be used for a variety of hand fractures, particularly in an emergency setting as well as definitive fixation. Method: There were 27 patients with different types of fracture of phalanges of hand in our study. Among them 19 male and 8 female patients [mean age -31.85 yrs]. There were 7 open fractures and 20 closed fractures. Out of 27 patients, 15 had fractures of proximal phalanx & 12 patients had fracture of middle phalanx. Our technique is to treat with k wire and plastic cap of spinal needle cap as a static external fixator device. One patient with tendon injury and one with skin loss which was treated by plastic surgical intervention. Result: At the end of 3 months of follow up, range of movements and TAM score out of 27 patients 19 had an excellent result (range 220-260), 5 patients had a good result (range 180-219)and 3 with fair result (range 130-179). Conclusion:This technique is simple, low cost, reproducible, easy applicabilty in the management of fractures involving the small bones of the fingers where complex fixators are not available or costly or needed expertise. Complex Unstable fractures can be converted into stable fractures by this robust and reproducible method. We recommend this simple, low cost, 'easy to construct and easy to use' fixator in the management of fractures involving the small bones of the fingers.

Syringe needle-cap use as novel, static, uni-planar or bi-planar, mini-external fixator for treatment of intra-condylar phalangeal fractures

“…Although dynamic constructs do have inherent benefits when treating periarticular and articular fractures, they also carry certain risks including pin tract infection and hardware breakage. 12,13 In addition, not all fractures are adequately stable for initial treatment with a dynamic construct. Most available commercial dynamic fixation devices are costly bulky, and not readily available.…”