Management of intra-articular fracture of the fingers via mini external fixator combined with limited internal fixation.
BACKGROUND
Intra-articular fractures of the fingers are common problems to emergency physicians and hand surgeons. Inappropriate management of these injuries may result in chronic pain, stiffness, deformity, or post traumatic arthritis. Ideal treatment necessitates the restoration of a stable and congruent joint that will allow early mobilization. The purpose of this study was to investigate the results of intra-articular fracture of the fingers by mini external fixator combined with limited internal fixation.


METHODS
From May 2005 to May 2007, a total of 26 patients with intra-articular fracture of the fingers were treated by mini external fixator combined with limited internal fixation. Of the 26 cases, 11 involved in metacarpophalangeal joint, and 15 interphalangeal joint in proximal interphalangeal. Kirschner wire, mini wire and absorbable suture were used for limited internal fixation. All patients were followed up and patients were accomplished with total active motion (TAM) of fingers.


RESULTS
All patients were reviewed by an independent observer. The mean follow up was 13 months (range 9 to 24 months). Subjective, objective and radiographic results were evaluated. X-ray films revealed fracture union and the average radiographic union time was 7 weeks with a range of 5 - 12 weeks and the phalange shortening or rotation in 2 cases, joint incongruity (less than 1 mm) and joint space narrowing in 3 cases respectively. Phalangeal shortening or rotation was observed in 2 cases and joint incongruity or joint space narrowing was observed in 3 cases. An artificial implant was performed on one case for traumatic arthritis 1.5 years after surgery. Based on TAM the overall good-excellent rate of joint motion function was 80.8%.


CONCLUSIONS
Mini external fixator combined with limited internal fixation is a reliable and effective method for treatment of intra-articular fracture of the fingers.
Li
Wen-jun
WJ
Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
Tian
Wen
W
Tian
Guang-lei
GL
Chen
Shan-lin
SL
Zhang
Chang-qing
CQ
Xue
Yun-hao
YH
Li
Zhong-zhe
ZZ
Zhu
Yin
Y
D000293:Adolescent; D000328:Adult; D016267:External Fixators; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D057072:Intra-Articular Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult