The S-Quattro in the Management of Acute Intraarticular Phalangeal Fractures of the Hand

Abstract

Intraarticular phalangeal fractures of the hand are difficult and challenging to manage. Dynamic external fixation devices offer the advantages of allowing distraction of the impacted fracture and early joint mobilization. We present our study of 100 patients with a variety of fractures who were treated with the S-Quattro technique over a 6-year period, with an average follow-up of 10.5 months. The mean active range of motion regained was 92 degrees for proximal interphalangeal joints (81 fractures), 82 degrees for distal interphalangeal joints (10 fractures), 91 degrees for metacarpophalangeal joints (6 fractures) and 80 degrees for interphalangeal joints of the thumb (3 fractures). Only nine patients complained of mild or moderate pain. Postoperative radiographic appearances were satisfactory in all but five out of the 100 patients. This device is a simple and effective technique for the management of these difficult fractures. It offers advantages in terms of versatility, ease of application, good tolerance by patients, few complications and good outcome.

A New Dynamic External Fixation Method in Finger Replantations and Toe-To-Hand Transfers

“…Bu yöntem-lerin tendon yapışıklığı, kapsül veya ligamanlarda fibrozis oluşturması, kırık parçada avasküler nekroz oluşturması gibi komplikasyonları mevcuttur (6,7). Ayrıca eklem yüzeyinden geçen K-teli fiksasyonları eklem yüzeyinde hasar oluşturmak-ta ve erken hareketlendirmeye engel teşkil etmektedir.…”

A Modified Technique of Using the S-Quattro External Finger Fixation System- A Case Report

“…The patient also underwent a limited internal fixation of the fracture fragment using a 1.6 mm Kirschner wire, followed by application of the S-Quattro external fixator as previously de scribed ( Fig. 2) [6].…”

“…The Stockport Serpentine Spring System, abbreviated to the S-Quattro, is a dynamic external fixator that has been used for intraarticular phalangeal fractures with good results [5][6][7]. It consists of a unique dual, parallel but opposing action spring column system.…”

Delayed treatment of unstable proximal interphalangeal joint fracture-dislocations with a dynamic external fixator

“…Unstable PIPJ fracture-dislocations and pilon fractures present a particularly difficult problem to treat, due to difficulty in reducing multiple displaced fracture fragments, compounded by the necessity for early joint motion to prevent stiffness. A variety of distraction systems have been described for immediate treatment of these injuries, with the aim being to reduce fracture fragments with ligamentotaxis, while allowing simultaneous early joint motion [1][2][3][4][5][6][7] . The vast majority of patients were treated as soon as possible after the inciting injury.…”

“…The vast majority of patients were treated as soon as possible after the inciting injury. Early treatment, according to recommendations in the literature, is crucial, to reduce any subluxation and institute early mobilization 7 . In addition, immobilization for longer than 3 weeks can result in permanent loss of motion 8 .…”