External Fixation of Closed Metacarpal and Phalangeal Fractures of Digits. A Prospective Study of One Hundred Consecutive Patients

Abstract

Stable and undisplaced phalangeal and metacarpal fractures treated with strapping or functional splinting and controlled active exercises offer from about 70 to 80% of good results. The goal of treatment of closed unstable and displaced fractures should be to achieve similar or better outcome. External fixation combines the simplicity of time-honoured fixation with K-wires and an external frame to increase rigidity. This combination was used in a prospective study of 100 consecutive patients with closed fractures of the proximal and middle phalanges and the distal three-quarters of the metacarpal bones. Good clinical results (TAM > or = 230 degrees) were obtained in 76% of isolated phalangeal fractures, in all metacarpal fractures and in 89% of multiple fractures.

Results of surgical treatment in metacarpal shaft fractures using low profile mini plates

“…[1][2][3][4]10,24,25] In vitro biomechanical comparative studies have shown that dorsal plating is the most stable fixation method. [2,10,33,34] K wire fixation may be made percutaneously in a cross, transverse, or intramedullary manner.…”

“…[2][3][4]6,11,13,15,20,22,23] Surgical methods include percutaneous or open Kirschner wire fixation, intramedullary fixation, open or percutaneous interfragmentary screw fixation, and external fixation. [1,2,10,16,24,25] Kirschner wires are the most commonly used fixation materials after closed or open reduction. [2,15] However, late initiation of movement resulting in a stiff hand, pin tract infection, and pin migration are the disadvantages of this method.…”

Percutaneous Distraction Pinning for Metacarpophalangeal Joint Stabilization After Blast or Crush Injuries of the Hand

“…Omokawa et al [11] reported good-to-excellent ROM in 43 of 51 patients. Margic [10] devised a ''simple'' external fixation device for treatment of phalangeal and metacarpal fractures. The device necessitates the use of ''a thin, shaped connecting element with 2 perpendicular holes secured with screws.''…”

Ensaio experimental para tratamento cirúrgico das fraturas transversas da falange proximal – Técnica com parafuso intramedular cônico de compressão versus placa de compressão lateral

“…[5][6][7] Essas complicaç ões são frequentemente causadas pelo pouco conhecimento da biomecânica desse órgão, pela crença infundada de que todas as fraturas da mão serão resolvidas com o tratamento conservador ou pela pouca cooperação dos pacientes. 8 Na busca de minimizar essas complicaç ões, foi descrito o posicionamento lateral da placa, por Mantovanni et al, 9 que não abordam o tendão extensor para evitar aderência tendinosa e rigidez articular.…”