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

Abstract

Background: Comminuted intra-articular phalanx fractures are complicated injuries often treated with external fixation. Syringe needle- cap can be an excellent mini-external fixators because they are radiolucent, readily available, inexpensive, simple, safe and easy to use. Our cases received a novel treatment in the form a syringe needle-cap/mini external fixator that was originally placed in static mode for 3 weeks and then later removed in OPD visit to a dynamic-mode of ROM to allow rehabilitation of the PIPJ/DIPJ. Our cases illustrates the power and utility of this ‘static’ uniplanar or biplanar stable technique to treat intra-condylar phalanx fractures and achieved good functional recovery of finger.Methods: This was a prospective case study covering period from January 2021 to May 2022 at department of plastic surgery, Command Hospital, Chandimandir, Panchkula, Haryana, India. 10 young male patients were presented with intra-articular fractures of phalanx. All patients had undergone pre-operative and post procedure X-rays for evaluation. A static external fixator consisting of a uniplanar or biplanar 2 ml syringe needle-cap and 0.8mm small size (3-4 cm) Kirschner wires as an optimal fixator across the fractured joint. K-wires were removed in OPD visit after 3 weeks to dynamize the ROM of affected joint of finger post-operatively.Results: 10 male patients were studied with average age of 28 years. 06 of them are intra-condylar fractures at PIP joints and rest are intra-articular fractures. After 3 weeks, we removed this fixator device and started controlled physiotherapy. End results notified in our study were achievement of good functional recovery of finger ROM at 3 months follow up.Conclusions: Syringe needle-cap use as mini-external fixation should be considered as a novel tool in the treatment of comminuted intra-articular phalangeal fracture.