Functional Outcome Evaluation of Phalangeal and Metacarpal Fractures Treated With Jess Fixation

Abstract

BACKGROUNDFractures of metacarpals and phalanges are the most common fractures of the upper extremity and account for 10% of total such cases. The outer rays of the hand are most commonly injured. The incidence of metacarpal and phalangeal fractures is most common in males and peaks at the age of 10-40 years a time when the athletic injury and industrial exposure is the greatest. Unfortunately, the metacarpal and phalangeal fractures are often neglected or regarded as trivial injuries. The Proximal Phalanx (PP) of the fingers, fractures are more frequently than the middle or distal phalanges. The deformity with considerable displacement is typical when the PP is fractured. Most fractures are functionally stable either before or after Closed Reduction (CR) and fare well with protective splint and early mobilisation. Closed treatment has gained a poor reputation in unstable comminuted, juxtaarticular and open fractures because of problems of malunion, stiffness and sometimes loss of skin or other soft tissues. Open reduction and internal fixation with K wires, plates and screws further compromises injured soft tissues and leads to infection and stiffness. On the other hand, external fixation allows fracture reduction to normal bone length via a rigid external support. Stiffness can be prevented by mobilisation of joints proximal and distal to the fracture.