Management of fractures of metacarpals and phalanges of hand with UMEX (universal mini external fixator)

Author(s): Dr. SK Venkatesh Gupta, Dr. Venkaiah M, Dr. Pavan Nutakki

Abstract: Complex fracture of metacarpals and phalangeal bones in the hand are difficult to treat, external fixator is an effective method of treatment particularly when internal fixation is not possible due to communication and associated soft tissue injury. This particular study is to evaluate the outcome of metacarpal and phalangeal fractures managed with mini external fixator in order to assess their effectiveness, functional outcome and complications and to make recommendations regarding potential applications. In our study we have included 45 cases out of which16 are metacarpal, 15 proximal phalanx, 14 middle phalanx. All cases are followed up at regular intervals of 4 weeks, 8 weeks, 12 weeks, 6 months. The functional results were excellent in 35.55%, good in 37.77%, fair in 13.33%, and poor in 13.33% of cases. We observed that UMEX is an adequate treatment modality for unstable phalangeal and metacarpal fractures which are open, intra-articular. UMEX simplifies the post-operative management of both injured finger and limb and it has better outcome in bony union & soft tissue wound healing particularly compound fractures. It can applied in local anaesthesia. UMEX method is not an alternative to established methods of management of small bone fractures but is an additional and useful tool in management of small bone fractures of hand, especially compound fractures.