Prevention of Thumb Web Space Contracture With Multiplanar External Fixation

Area of Science:

• Orthopedics
• Hand Surgery
• Reconstructive Surgery

Background:

• Thumb web space contracture is a disabling complication of hand trauma.
• Existing reconstructive procedures have limitations in correcting the deformity.
• Soft tissue injury to the hand often necessitates innovative stabilization techniques.

Purpose of the Study:

• To evaluate the efficacy of the Stryker Hoffmann II Micro External Fixator System for thumb web space reconstruction.
• To assess the device's ability to maintain thumb position and preserve web space function post-injury.
• To report on patient outcomes and complications associated with this external fixation technique.

Main Methods:

• Utilized the Stryker Hoffmann II Micro External Fixator System to connect the first and second metacarpals in five patients.
• Employed 1.6 or 2.0 mm self-drilling half-pins and 3 mm carbon fiber connecting rods for multiplanar stabilization.
• Applied the external fixator for an average of 5.5 weeks, allowing for hand mobilization as tolerated.

Main Results:

• The external fixator facilitated maximal thumb palmar abduction and allowed for intraoperative adjustments.
• Thumb web space was preserved in all five patients, with supple thumb circumduction and abduction/adduction maintained.
• No device-associated complications were reported during the treatment period.
• Average follow-up of 5 months showed positive functional outcomes with an average Quick DASH score of 35±5.

Conclusions:

• The Stryker Hoffmann II Micro External Fixator System is a viable and effective option for stabilizing the thumb and preserving the first web space following hand trauma.
• This technique offers adjustable multiplanar fixation, facilitating optimal thumb positioning and functional recovery.
• The absence of complications and positive functional outcomes suggest this method is safe and beneficial for patients with severe hand soft tissue injuries.