Management of severe hand trauma with a mini external fixateur

Maintenance of length, alignment, and mobility while affording ready access for wound care has traditionally been a problem in the management of severe hand trauma. However, miniaturization of existing components of external fixation has provided a significant step in the solution of this problem. Twenty-eight fractures in severely traumatized hands in 24 patients have been managed using a Hoffman mini external fixateur. The patients' mean age was 26.5 years. The dominant hand was involved 60% of the time, and 80% of the population was male. Most fractures (80%) were open injuries with marked comminution, often intra-articular, frequently the result of gunshot wounds (60%). Mini external fixation has afforded proper wound care and maintenance of desired alignment. Complications have been few, while improved results (alignment, range of motion, strength, fracture union), have been demonstrated. Our surgical technique, results, and some illustrative cases are presented.