A comparative study of the anatomical and functional outcome between Joshi’s External Stabilization System and Kirschner wire fixation technique for Extra-articular Metacarpal fracture

Abstract

Introduction & Objectives: Nowhere in the body, the form and function are so closely related to each other than in hand. Too often these fractures, treated as minor injuries result in major disabilities. Metacarpal fractures comprise between 18-44% of all hand fractures. While many metacarpal fractures do well without surgery, Proper preoperative plannin, surgical intervention wherever needed at a center with backing of equipment and implants with the application of the principles of biological fixation, rigid enough, aids in achieving stable fractures and the ability to allow early mobilization resulting in a good functional outcome. The aim of this study was to compare the outcome between JESS and K wire fixation techniques for extraarticular fractures of the metacarpals. Materials and Methods: 60 patients were allocated into two groups (Group A -30 & Group B -30), Group A underwent K-wire fixation and Group B underwent JESS fixation. Outcomes were measured based on Stability of fixation, tenderness at fracture site, Pin tract infection, Residual fixation, ROM achieved, Wrist and Mayo score, DASH score and VAS scoring system. Results: Parameters such as the stability of fixation, incidence of pin tract infections, recovery of good range of motion and the outcome was found to be 90%, 20%, 50% (in case of extension) and 83.67% (in case of flexion) and 60%(excellent outcome) respectively in Group B patients who were treated with JESS fixation. Conclusion:The results of this randomized comparative study showed that JESS fixation was more effective than K-wire fixation in treatment of Extra-articular metacarpal fractures, with emphasis to be provided on regular pin tract dressings and early and effective post-operative mobilization of the joints.