A Novel Mini External Fixation Technique versus Percutaneous Pinning in the Treatment of Phalanx Fracture in Hand.

Abstract

Objectives: Hand fracture is one of the most common fractures in the skeletal system. The present study aimed to introduce a newly designed external fixator and assess the results of treatment of patients with unstable and complex fractures of the proximal and middle phalanges of the fingers with two treatment methods: "fixation with percutaneous pins (PCP) + splint" and "fixation with mini external fixator.

Methods: In this prospective cohort study, patients with acute unstable and complex fractures of the proximal and middle phalanges of the second to fifth fingers were treated with two treatment methods, including "fixation with PCP + splint" and "the use of mini external fixator." At the final follow-up visit, union, pain, function, finger range of motion (ROM), and possible complications were considered.

Results: Among 52 patients included in the study, 33 cases were treated with a mini external fixator, and 19 patients underwent fixation with PCP and splint. All patients in both groups had a union, and none of them complained of pain during the final visit. Functional outcomes were good, and there was no statistically significant difference between the two groups. The mini external fixator group had a significantly greater finger ROM (P=0.012), with a lower number of physiotherapy sessions (P=0.018). Moreover, patients returned to work more promptly (P=0.012).

Conclusion: The treatment of unstable finger fractures with a mini external fixator had three advantages: the possibility of early initiation of finger movement and improvement of finger ROM, the need for fewer physical therapy sessions, and early return to work. It can be an effective treatment option for unstable and complex finger fractures.