Simplified Kirschner‑wire-based dynamic external fixator for unstable proximal interphalangeal joint fractures
| Autor: | Ahmad El-Tantawy, Tarek Mohamed Ali, Mohammed A. Ramadan, Mostafa Naguib |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
External fixator Sports medicine External Fixators Joint mobilization Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Finger Joint medicine Humans Orthopedics and Sports Medicine Kirschner wire Prospective Studies Range of Motion Articular Retrospective Studies Orthodontics 030222 orthopedics Hand Strength business.industry 030208 emergency & critical care medicine Treatment Outcome Radiological weapon Emergency Medicine Residual pain Surgery Range of motion business Interphalangeal Joint |
| Zdroj: | European journal of trauma and emergency surgery : official publication of the European Trauma Society. 48(1) |
| ISSN: | 1863-9941 |
| Popis: | Ligamentotaxis is a well-established treatment modality for treating challenging articular fractures. Many devices have been evolved to apply this principle to complex proximal interphalangeal joint (PIPJ) fractures. Although they gave satisfactory results, these devices were sometimes costly, complex and cumbersome. The aim of this study was to evaluate the short-term functional and radiological outcomes of treating complex intra-articular PIPJ fractures using a simplified, preloaded Kirschner‑wire (K‑wire)-based dynamic external fixator. Twenty consecutive patients with intraarticular PIPJ fractures, who fulfilled the study selection criteria, have been treated during 2018 and included in this prospective study after the approval of the responsible institutional ethics committee. Plain radiographs were used for assessing fracture reduction, congruity and healing. The visual analogue sore (VAS) and the Michigan Hand Outcome Questionnaire (MHQ) were used for functional evaluation. PIPJ range of motion (ROM) and hand grip-strength were also assessed. At the final follow-up, all patients had no residual pain. The average PIPJ-ROM was 76.4 ± 23.51°, and the average grip-strength was 85 ± 13.95% as compared to the healthy side. The mean normalized MHQ score was 83 ± 12.63 points, with 4, 13, and 3 patients had excellent, good, and fair results retrospectively. Complications included pin tract infection (one case), stress fracture related to the applied wires (one case), and flexion contractures (four cases; three of them were symptomatic). The used fixator technique is simple, reliable, available, reproducible, time-saving and cost-effective for managing complex PIPJ fractures while allowing early joint mobilization, which proven effective in achieving high satisfactory functional results. |
| Databáze: | OpenAIRE |
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