Jess Fixator for Metacarpal and Phalangeal Fracture

Abstract

The fractures of metacarpal and phalanges of the hand are the most common injury encountered in emergency department. Most often these injuries are neglected as minor injuries and later on develops a functional limit of the hand. Joshi’s external stabilizing system (JESS) fixator based on the principle of ligamentotaxis, stabilize the unstable and intraarticular fractures of metacarpal and phalangeal and also provides an environment for rapid soft tissue healing without further damaging the microvascular circulation. The study includes total number of 38 patients with a diagnosis of fracture of Metacarpal and phalanx of hand admitted in Nepal Medical college and Teaching Hospital who were treated with JESS fixator. The functional outcome after the removal of JESS fixator was assessed by calculating American Society for Surgery of Hand and Total Active flexion (ASSH TAF). Among the 38 patients, all fractures went to union with an average union period of 6 weeks. The mean period of treatment for metacarpal fractures was12 weeks and for phalangeal fractures 16 weeks by which time patients regained full functional activity of hand and returned back to their respective works. The functional outcome assessed by ASSH-TAF score was excellent in 28 patients, good in 10 patients and none of them had a poor result. The complication was seen in 9(23.68%) cases, superficial pin tract infection and K Wire Loosening. JESS fixator is cheap, easily available and less technically demanding, provides with an effective treatment for the metacarpal and phalanges fracture, as it provides adequate stability that allows early rehabilitation with soft tissue care and has got a good functional outcome

Outcome of Early Retrograde Closed Intramedullary Fixation of Fracture Shaft of Femur by Titanium Elastic Nail in Children

“…In this study, 30 cases were selected based on specific inclusion and exclusion criteria, mirroring the approach in [8]. The age range of patients was 6 to 14 years, with the majority (50%) falling between 9 and 11 years, 26.67% in the 12-14 years range, and 23.33% in the 6-8 years range.…”

Intramedullary Crossed K-wire Fixation for the Hand Fractures is a Useful Treatment Modality: A Prospective Observational Study

“…Though this procedure provides a good functional outcome, pin-track infection is seen in almost one-fourth of the patients. 25 The simplicity and cost-effectiveness of the device and fixation technique is countered by the fact that the patient has to carry the fixator which is physically discerned and may be uncomfortable for a few. Hence, this method of treatment is mostly reserved for comminuted and open injuries with bone loss.…”

“…In the present study all the fractures united at a mean period of 4.2 ± 6.8 weeks, which is the shortest duration as compared to other studies. 17 , 18 , 22 , 25 In addition, most of the patients were started with physiotherapy in immediate postoperative period. This can be attributed to extra stability after fixation of fracture with crossed percutaneous intramedullary K-wire.…”

Effects of Hand Function Rehabilitation Strategies in Fracture Recovery

“…On the other hand, Physical Therapists (PTs) concentrate on lowering pain, reducing inflammation, and regaining joint mobility using specific exercises and modalities [9][10] . The restoration of hand function and an enhanced quality of life are the results of this combined approach, which includes functional adaptation monitored by OTs and physical therapy under the control of PTs [11][12] .…”