Shyam Sundar Bakki1, Nageswara Rao Yennapu2, Anil Kumar Chollangi3, Vamsi Krishna Kurmana4, Ravi Teja Kolluru5
The human hand is the most vulnerable part of the body prone to a variety of injuries especially in industries, agricultural fields and adding to this increased road traffic accidents resulting in high incidence of phalangeal and metacarpal fractures particularly mutilating hand injuries, open fractures, comminuted fractures and intra-articular fractures. The purpose of the study is to evaluate the overall functional outcome of hand treated with JESS fixation for metacarpal and phalangeal fracture and to study the complications associated with their management.
MATERIALS AND METHODS
We have studied 30 patients with 37 fractures of metacarpals and phalanges of hand with JESS mini external fixator at Department of Orthopaedics, Rangaraya Medical College. The study was done from October 2012 to August 2014. Age of the patients range from 10-60 yrs. with most of the patients belong to 21-40 yrs. age group. The majority of the patients were male (M:F = 26:4). The sample size reflected the population visiting the trauma section of our department. Most of the fractures are caused by RTA and on right hand. Majority of the fractures are occurred in proximal phalanx, followed by metacarpal.
All patients were followed for a minimum of 6 months and the mean follow-up period was 33.77 wks. The mean fracture healing in our study was 12.77 weeks. Reviewing the literature, the average radiological healing of phalanges and metacarpals is 4-5 months, which ranges from 1-17 months. The fracture healing time in our study compares favourably with those reported in the literature. Mean duration of implant (JESS) application was 4.42 wks. Complications like pin-tract infection encountered in five patients, three pin loosening, one total stiffness and 10 of them had partial stiffness.
JESS fixation provides an adequate basis for bone healing is a good and simple alternative to standard treatment especially in open, intraarticular, comminuted and multiple phalangeal and metacarpal fractures.