The use of minimally invasive fixation in fractures of the hand — the minifixator concept

Pennig, D.; Gausepohl, T.; Mader, Konrad; Wulke, Andreas P.

doi:10.1016/s0020-1383(99)00268-5

Cited by 22 publications

(13 citation statements)

References 11 publications

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“…had excellent results. The sample size for treatment with extension block cast (3), dynamic traction (1), mini external-fixator (4), and OR and IF with SS-wire (2) was extremely small to compare the results with other studies 679111316. Our study had an average TAM of 210°, and mean grip strength of 52 pounds.…”

Section: Discussionmentioning

confidence: 98%

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Outcome of closed proximal phalangeal fractures of the hand

Singh

Jain

Mruthyunjaya

et al. 2011

IJOO

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Background:The proximal phalanx (PP) of the fingers is fractured more frequently than the middle or even distal phalanges. The problems of malunion, stiffness and sometimes loss of skin or other soft tissues associated with PP fracture increases the disability. The optimum treatment depends on fracture location, fracture geometry and fracture stability. The objective of the study was to analyse the treatment outcome in a series of closed proximal phalangeal fractures of the hand.Materials and Methods:Eighty-four proximal phalangeal fractures in 68 patients were enrolled from 2007 to 2009. The treatment modalities were broadly categorised into two groups, Group A consisted of conservative treatment, and Group B consisted of surgical treatment. Group A included 47 digits treated with closed reduction (CR) with immobilization (n=43), extension block cast and dynamic traction (n=4), while 37 digits were treated in Group B, which included closed or open reduction (OR) and internal fixation (IF) with K-wires (n=31), OR and IF with stainless-steel wiring (n=2), and mini external-fixator (n=4). Belsky's criteria and Gingrass’ criteria were used for assessment of finger injuries and to assess the efficacy of conservative and surgical modalities for closed proximal phalangeal fractures of the hand.Results:Average period of follow-up was 1 year (range 10-14 months). The excellent to good results seen in Groups A and B were 89% and 92%, respectively. Six complications were seen in Group A, which included four cases with malunion and two cases with digital stiffness. Three complications were seen in Group B, which included one each of malunion, digital stiffness and extensor lag. Overall, maximum poor results (n=4) were seen with CR and buddy strapping.Conclusion:Conservative treatment is an inexpensive method, particularly suitable for stable fractures, and in patients who are poor candidates for surgery, Surgical modalities have distinct advantage of stable fixation, but with added risk of digital stiffness. Percutaneous pinning is a reliable, most commonly used surgical modality and technically easier. Both conservative and surgical modalities have good efficacy when used judiciously

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Section: Discussionmentioning

confidence: 98%

“…Mini external fixator141213 was mainly used for the displaced and comminuted fractures. Predrilling was done bicortically with a 1.5-mm drill bit and two 2-mm pins were inserted dorsolaterally, proximal and distal to the fracture.…”

Section: Methodsmentioning

confidence: 99%

Outcome of closed proximal phalangeal fractures of the hand

Singh

Jain

Mruthyunjaya

et al. 2011

IJOO

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“…This is to maintain length and alignment that are quintessential for later intervention and ultimate hand function. 7,8 Our patients required soft tissue distraction in view of their late presentation. Application of the UMEX distractor under local anaesthesia helped us avoid general anaesthesia in the first setting.…”

Section: Discussionmentioning

confidence: 99%

Use of Universal Mini External Fixator in the Management of Postosteomyelitic Defects in Short Tubular Bones in the Paediatric Population

Kawoosa

Wani

Shah

et al. 2015

Journal of Orthopaedics, Trauma and Rehabilitation

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a b s t r a c tAims: The purpose of this study was to evaluate the results of reconstruction of postosteomyelitic defects in short tubular bones in a paediatric population using a universal mini external fixator (UMEX). Settings and design: This was a prospective case series based on 10 consecutive cases and followed up for an average period of 3.5 years. Materials and methods: Ten patients (mean age: 10.2 years) with an average shortening of 4 cm of the corresponding digit were operated upon using soft tissue distraction by UMEX followed by interposition bone grafting from the iliac crest. The second metacarpal was involved in five patients, the first metacarpal in three patients, and the proximal phalanx of the right big toe was involved in two patients. Results: All of the patients achieved union at the graft host site at an average of 12 weeks and an average of 3.8 cm lengthening of the digit was achieved. All patients had improved digit length, and function and appearance of the hand and toe. Apart from a minor pin tract infection and stiffness, there were no major complications. Final average follow up at 3.5 years did not show any recurrence of infection or loss of correction. Conclusion: We believe that UMEX is a versatile method of managing postosteomyelitic defects in short tubular bones, with fewer complications and a high union rate, even in situations in which bone fragments are small and difficult to handle with other methods.

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“…screws 5,6,9 -11 and mini-external fixators 5,6,[12][13][14][15][16][17][18][19][20][21][22][23] have been used, depending on the fracture pattern and local tissue conditions. Mini-external fixation devices, either manufactured or custom made, were used in most reports for the treatment of open fractures with soft tissue injury or bone loss and for severely displaced comminuted intra-articular fractures, based on the ligamentotaxis principle.…”

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confidence: 99%