Human hand has evolved into an organ of exceptional function which is capable of complex movements & manipulation. Varieties of functions vary widely from pinch grip, hook function to powerful grip for lifting heavy weights. 15% of hand injuries are of Metacarpals and phalanges. Phalangeal fractures either closed or open are the most common injuries of the hand. These injuries can be treated conservatively or operatively depending on nature of injuries, fracture pattern & fracture stability.
Principle management involves restoration of articular congruity, fixation of Fractures with external fixation devices.
Materials and Methods: We did a prospective, non randomized study for a duration 6 months for a patient population of 17 who had phalangeal & metacarpal fractures. After ethical clearance & consent they were included in the study. Fractures were stabilized by threaded k wires, link joints and connecting rods. Reduction was achieved under c-arm guidance. Patient were followed up periodically for pin tract infection, loosening of k wires & link joint loosening.
Excellent results were achieved in majority of patients and with few patients in average & poor results.
Results: Out of 17 patients 10 were males & 7 were females, most of the injuries are due to agricultural accidents, 76% of patients had good union with 24% had delayed union,65% were open fractures & 35% closed injuries, 11 were extra- articular & 6 were intra-articular fractures, The majority fractures were of proximal phalanx followed by metacarpals, 47% patients had excellent outcomes, 29% with good results, 18% average results & 6% poor results these were due to the pin tract infection, loosening, collapse of fracture, angulation & side to side translation.
Conclusion: Our study showed that extra-articular fractures gave a better results, whereas intra- articular fractures gave average results due to stiffness of joints. And at the same time external fixator gave a better outcome.