Management of metacarpal and phalangeal fractures with JESS fixator: A prospective study

Author(s): Dr. KV Dhanwantary Naidu

Abstract: The human hand architected to show an exceptional movements and is often a most vulnerable to various degree of injuries caused often by road traffic accidents and industrial accidents. Treatment of hand injuries involves in joint range improvement and redevelopment of coordinative movements. Joshi’s external stabilizing system (JESS) provides a stable skeletal environment with early tissue healing and immediate active and passive mobilization of the uninjured adjacent joints. This study designed to assess the efficacy of JESS in management of Hand injuries. Study includes 50 patients of both sexes and all age groups with open or close type of hand injuries. All the patients were allowed to complete clinical and radiological assessment before and after surgical procedure along with subsequent follow up. Various types of distractors (30%) were applied because majority fractures were intra-articular and in 18% cases basic and extended hand frames were used. Fixators was removed within 6 weeks and in 68% wounds were healed at that time of fixator removal. Swelling was commonly associated complications in 32% cases. The incidence of non-union and delayed union of fractures was 8%, 10% respectively. At the time of final follow up 62.8% metacarpophalangeal joints, 64% of interphalangeal joints, 63% of proximal metacarpophalangeal joints, 63.5% of distal metacarpophalangeal joints and 62% of wrist joints regained their normal movements. In 74% cases grip strength was remains normal. JESS is simple, modular and low expensive. It assists the surgeon in obtaining tissue stabilization, spontaneous revascularization and tissue expansion by gradual and controlled distraction.

DOI: https://doi.org/10.22271/ortho.2018.v4.i1f.55