External fixation for phalangeal and metacarpal fractures

Area of Science:

• Orthopedic Surgery
• Traumatology
• Hand Surgery

Background:

• Hand fractures, particularly open and comminuted types, present significant treatment challenges.
• Unstable fractures with severe soft-tissue compromise require robust stabilization methods.

Purpose of the Study:

• To evaluate the efficacy and outcomes of external fixation with a mini-Hoffmann device for treating phalangeal and metacarpal fractures.
• To assess the complication rates and functional results in patients with complex hand fractures.

Main Methods:

• A retrospective study of 33 patients treated with mini-Hoffmann external fixation for phalangeal (29) and metacarpal (7) fractures between 1987 and 1993.
• Inclusion of patients with open (27) and comminuted (25) fractures, with tendon involvement in 12 cases.
• Mean follow-up period of 4.4 years.

Main Results:

• All 33 fractures achieved bony union.
• Complications occurred in 10 fractures, with 2 requiring fixator repositioning.
• Metacarpal fractures demonstrated better functional outcomes than phalangeal fractures.
• Fractures of the middle phalanx showed better recovery compared to the proximal phalanx.
• Twenty-eight out of 33 patients reported satisfaction with the treatment outcome.

Conclusions:

• External fixation using the mini-Hoffmann device is a suitable technique for stabilizing unstable and open hand fractures, even with severe soft-tissue injuries.
• The technique provides reliable healing and satisfactory functional results for complex phalangeal and metacarpal fractures.
• Specific fracture locations (metacarpal, middle phalanx) correlate with better functional recovery.