Research Article
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Falanks ve Metakarpal Kemik Kırıklarında Eksternal Fiksatör Uygulamaları

Year 2025, Volume: 9 Issue: 1, 10 - 18, 01.04.2025

Gözde Kirgın , Tufan Kaleli

Abstract

Amaç: El yaralanmaları, hastaların günlük yaşamlarında yaptıkları işleri olumsuz etkileyerek büyük bir stres kaynağı ve yaşamdan kopma nedeni olabilir. Bu çalışma, kurumumuzda metakarpal ve falanks kırıkları için mini harici fiksatörle ameliyat edilen hastalarda kırık kaynaması ve deformitenin varlığını değerlendirmeyi amaçlamıştır.

Yöntem: Falanks ve metakarpal kemik kırıkları nedeniyle harici fiksasyon uygulanan toplam 148 hasta retrospektif olarak değerlendirildi. Hastaların radyografik muayeneleri yapıldı ve kırık kaynaması ve deformite değerlendirildi. Sonuçlar, eklem hareketleri uygulanarak ve Toplam Aktif Eklem Hareket Aralığı (Strickland-Glogovac parmak fonksiyon ölçeği) puanlanarak klinik olarak değerlendirildi.

Bulgular: Hastalar travmalarından sonraki ilk üç gün içinde ameliyat edildi; Hastaların 17'sinde (%15.3) metakarpal kırık, 94'ünde (%84.7) falanks kırığı, metakarpal kırıkların 8'inde (%47) ikinci metakarpal kırık ve falanks kırığı olan 94 hastanın 26'sında (%27.6) beşinci parmak kırığı vardı. Strickland-Glogovac parmak fonksiyon skalasına göre aktif eklem hareket açıklığı >150 (mükemmel) olan hasta sayısı 45, 125–149 (iyi) olan hasta sayısı 36, 90–124 (orta) olan hasta sayısı 20 ve <90 (kötü) olan hasta sayısı 10 idi. Toplamda 81 hastada mükemmel ve iyi sonuçlar bulundu.

Sonuç: Mini eksternal fiksatörler, elin tübüler kemik kırıkları için cerrahi seçenekler arasında daha sık tercih edilmelidir çünkü uygulanması kolaydır, tatmin edici stabiliteye sahiptir, güvenlidir, ağrısız erken mobilizasyona izin verir ve tedavi seçeneklerinde çok yönlülük sağlar.

Keywords

eksternal fiksasyon mini eksternal fiksatör falanks kırığı metakarpal kırıklar K-teli

References

  • 1. Weir TB, Abzug JM, Gaston RG, Osterman MN, Osterman AL. Hand Fractures-Management and the Complications That Inevitably Occur: Metacarpal Fractures. Instr Course Lect. 2024;73:285-304. PMID: 38090905.
  • 2. Christodoulou N, Asimakopoulos D, Kapetanos K, Seah M, Khan W. Principles of management of hand fractures. J Perioper Pract. 2023;33(11):342-9. doi: 10.1177/17504589221119739.
  • 3. Poggetti A, Fagetti A, Lauri G, Cherubino M, Borelli PP, Pfanner S. Outcomes of 173 metacarpal and phalangeal fractures treated by intramedullary headless screw fixation with a 4-year follow-up. J Hand Surg Eur Vol. 2021;46(5):466-70. doi: 10.1177/1753193420980324.
  • 4. Ahmad S, Gupta T, Ansari S, Jain A, Barik S, Singh V. Intramedullary Crossed K-wire Fixation for the Hand Fractures is a Useful Treatment Modality: A Prospective Observational Study. Strategies Trauma Limb Reconstr. 2022;17(2):74-80. doi: 10.5005/jp-journals-10080-1556.
  • 5. Korkmaz O, Abourdan J, Birinci M, Bostanci B, Kara A. The Use of External Fixator and Iliac Crest Bone Graft in Traumatic Metacarpal Bone Defect. J Orthop Case Rep. 2022;12(12):43-49. doi: 10.13107/jocr.2022.v12.i12.3458.
  • 6. Hadeed A, Werntz RL, Varacallo MA. External Fixation Principles and Overview. 2023 Aug 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan- PMID: 31613474.
  • 7. Malik S, Herron T, Taqi M, Rosenberg N. Fifth Metacarpal Fracture. 2024 Feb 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 29261999.
  • 8. McDaniel DJ, Rehman UH. Phalanx Fractures of the Hand. 2023 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 32491557.
  • 9. Akdemir M, Kiliç AĪ, Kurt C, Çapkin S. Open Reduction and Plate Fixation, External Fixator, and Conservative Treatment for Intra-articular Distal Radius Fractures. Cureus. 2024;16(1):e52014. doi: 10.7759/cureus.52014.
  • 10. Kamil R, McKenna E, Romeo P, Burke O, Zakusylo A, Andemichael A, et al. The Role of External Fixation in the Treatment of Distal Radius Fractures. Cureus. 2024;16(7):e64346. doi: 10.7759/cureus.64346.
  • 11. Lee BJ, Lee CH, Lee YH, Woo S. Intramedullary fixation of metacarpal and phalangeal bone fractures with bioabsorbable Mg K-wire in 20 cases. Eur J Orthop Surg Traumatol. 2023;33(7):2911-20. doi: 10.1007/s00590-023-03503-3.
  • 12. Widanage KND, De Silva MJ, Dulantha Lalitharatne T, Bull AMJ, Gopura RARC. Developments in circular external fixators: A review. Injury. 2023 Dec;54(12):111157. doi: 10.1016/j.injury.2023.111157.
  • 13. Tun S, Sekiya JK, Goldstein SA, Jebson PJ. A comparative study of mini-external fixation systems used to treat unstable metacarpal fractures. Am J Orthop (Belle Mead NJ). 2004 Sep;33(9):433-8. PMID: 15509107.
  • 14. Li Y, Zhang H. Effect of Joint Use of External Minifixator and Titanium Lockplate on Total Active Motion Range and Hand Function Recovery in Comminuted Metacarpal and Phalanx Fracture Patients. J Healthc Eng. 2022;2022:3566364. doi: 10.1155/2022/3566364.
  • 15. Houshian S, Ghani A, Chikkamuniyappa C, Sakka SA. Single-stage distraction correction for neglected dorsal fracture dislocations of the proximal interphalangeal joint: a report of eight cases. J Hand Surg Eur Vol. 2008;33(3):345-9. doi: 10.1177/1753193408091351.
  • 16. Yaseen G, Qureshi KK, Hussain A. Results of mini external fixator in metacarpal and phalangeal fractures: Mini External Fixator in Metacarpal And Phalangeal Fractures. Pak Armed Forces Med J. 2016;66(5):715-19.
  • 17. Thakur A. Operative management of metacarpal and phalangeal fractures. J Med Educ Res. 2008; 10(1):1-9.
  • 18. Li WJ, Tian W, Tian GL, Chen SL, Zhang CQ, Xue YH, et al. Management of intra-articular fracture of the fingers via mini external fixator combined with limited internal fixation. Chin Med J (Engl). 2009;122(21):2616-9. PMID: 19951580.
  • 19. Drenth DJ, Klasen HJ. External fixation for phalangeal and metacarpal fractures. J Bone Joint Surg Br. 1998;80(2):227-30. doi: 10.1302/0301-620x.80b2.8131
  • 20. Dailiana Z, Agorastakis D, Varitimidis S, et al. Use of a mini-external fixator for the treatment of hand fractures. J Hand Surg Am. 2009;34(4):630-636. doi:10.1016/j.jhsa.2008.12.017.
  • 21. Margić K. External fixation of closed metacarpal and phalangeal fractures of digits. A prospective study of one hundred consecutive patients. J Hand Surg Br. 2006;31(1):30-40. doi: 10.1016/j.jhsb.2005.09.013.
  • 22. Ahmad S, Gupta T, Ansari S, Jain A, Barik S, Singh V. Intramedullary Crossed K-wire Fixation for the Hand Fractures is a Useful Treatment Modality: A Prospective Observational Study. Strategies Trauma Limb Reconstr. 2022;17(2):74-80. doi: 10.5005/jp-journals-10080-1556.
  • 23. Gupta R, Singh R, Siwach R, Sangwan S, Magu NK, Diwan R. Evaluation of surgical stabilization of metacarpal and phalangeal fractures of hand. Indian J Orthop. 2007;41(3):224-9. doi: 10.4103/0019-5413.33687.
  • 24. El-Shaera AF, Shams El-Deenb AF, El-Deen Abu Husseinb AS , et al. Results of management of recent fractures of phalanges of the hand by a mini external fixator. Menoufi a Medical Journal 2015, 28:965–70. doi: 10.4103/1110-2098.173689
  • 25. Tank PM and Patel NB. Simple low cost static external fixators for phalangeal fractures of hand. Int J Orthop Sci. 2018;4(1):714-20. doi: 10.22271/ortho.2018.v4.i1k.103

External Fixator Applıcatıons in Phalanx and Metacarpal Bone Fractures

Year 2025, Volume: 9 Issue: 1, 10 - 18, 01.04.2025

Gözde Kirgın , Tufan Kaleli

Abstract

Aim: Hand injuries can be a great source of stress and a cause of disconnection from life by negatively impacting the work that patients do in their daily lives. This study aimed to evaluate the presence of fracture union and deformity in patients operated on with a mini external fixator for metacarpal and phalanx fractures in our institution.

Method: A total of 148 patients who underwent external fixation due to phalanx and metacarpal bone fractures were retrospectively evaluated. The patients' radiographic examinations were performed, and fracture union and deformity were evaluated. The results were clinically assessed by applying joint movements and scoring the Total Active Joint Range of Motion (Strickland-Glogovac finger function scale).

Results: The patients were operated on within the first three days after their trauma; 17 (15.3%) of the patients had metacarpal fractures, 94 (84.7%) had phalanx fractures, 8 (47%) of the metacarpal fractures were 2nd metacarpal fractures, and 26 (27.6%) of the 94 patients with phalanx fractures had 5th finger fractures. According to the Strickland–Glogovac finger function scale, the number of patients with active joint range of motion >150 (excellent) was 45, the number of patients with 125–149 (good) was 36, the number of patients with 90–124 (moderate) was 20, and the number of patients with <90 (poor) was 10. In total, excellent and good results were found in 81 patients.

Conclusion: Mini external fixators should be preferred more frequently among surgical options for tubular bone fractures of the hand because they are easy to apply, have satisfactory stability, are safe, allow for painless early mobilization, and provide versatility in treatment options.

Keywords

external fixation mini external fixator phalanx fracture metacarpal fractures K–wire

Ethical Statement

Etik kurul onay belgesi dosyalar bölümünde sunulmuştur.

Supporting Institution

destekleyen bir kurum ya da sponsor bulunmamaktadır.

References

  • 1. Weir TB, Abzug JM, Gaston RG, Osterman MN, Osterman AL. Hand Fractures-Management and the Complications That Inevitably Occur: Metacarpal Fractures. Instr Course Lect. 2024;73:285-304. PMID: 38090905.
  • 2. Christodoulou N, Asimakopoulos D, Kapetanos K, Seah M, Khan W. Principles of management of hand fractures. J Perioper Pract. 2023;33(11):342-9. doi: 10.1177/17504589221119739.
  • 3. Poggetti A, Fagetti A, Lauri G, Cherubino M, Borelli PP, Pfanner S. Outcomes of 173 metacarpal and phalangeal fractures treated by intramedullary headless screw fixation with a 4-year follow-up. J Hand Surg Eur Vol. 2021;46(5):466-70. doi: 10.1177/1753193420980324.
  • 4. Ahmad S, Gupta T, Ansari S, Jain A, Barik S, Singh V. Intramedullary Crossed K-wire Fixation for the Hand Fractures is a Useful Treatment Modality: A Prospective Observational Study. Strategies Trauma Limb Reconstr. 2022;17(2):74-80. doi: 10.5005/jp-journals-10080-1556.
  • 5. Korkmaz O, Abourdan J, Birinci M, Bostanci B, Kara A. The Use of External Fixator and Iliac Crest Bone Graft in Traumatic Metacarpal Bone Defect. J Orthop Case Rep. 2022;12(12):43-49. doi: 10.13107/jocr.2022.v12.i12.3458.
  • 6. Hadeed A, Werntz RL, Varacallo MA. External Fixation Principles and Overview. 2023 Aug 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan- PMID: 31613474.
  • 7. Malik S, Herron T, Taqi M, Rosenberg N. Fifth Metacarpal Fracture. 2024 Feb 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 29261999.
  • 8. McDaniel DJ, Rehman UH. Phalanx Fractures of the Hand. 2023 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 32491557.
  • 9. Akdemir M, Kiliç AĪ, Kurt C, Çapkin S. Open Reduction and Plate Fixation, External Fixator, and Conservative Treatment for Intra-articular Distal Radius Fractures. Cureus. 2024;16(1):e52014. doi: 10.7759/cureus.52014.
  • 10. Kamil R, McKenna E, Romeo P, Burke O, Zakusylo A, Andemichael A, et al. The Role of External Fixation in the Treatment of Distal Radius Fractures. Cureus. 2024;16(7):e64346. doi: 10.7759/cureus.64346.
  • 11. Lee BJ, Lee CH, Lee YH, Woo S. Intramedullary fixation of metacarpal and phalangeal bone fractures with bioabsorbable Mg K-wire in 20 cases. Eur J Orthop Surg Traumatol. 2023;33(7):2911-20. doi: 10.1007/s00590-023-03503-3.
  • 12. Widanage KND, De Silva MJ, Dulantha Lalitharatne T, Bull AMJ, Gopura RARC. Developments in circular external fixators: A review. Injury. 2023 Dec;54(12):111157. doi: 10.1016/j.injury.2023.111157.
  • 13. Tun S, Sekiya JK, Goldstein SA, Jebson PJ. A comparative study of mini-external fixation systems used to treat unstable metacarpal fractures. Am J Orthop (Belle Mead NJ). 2004 Sep;33(9):433-8. PMID: 15509107.
  • 14. Li Y, Zhang H. Effect of Joint Use of External Minifixator and Titanium Lockplate on Total Active Motion Range and Hand Function Recovery in Comminuted Metacarpal and Phalanx Fracture Patients. J Healthc Eng. 2022;2022:3566364. doi: 10.1155/2022/3566364.
  • 15. Houshian S, Ghani A, Chikkamuniyappa C, Sakka SA. Single-stage distraction correction for neglected dorsal fracture dislocations of the proximal interphalangeal joint: a report of eight cases. J Hand Surg Eur Vol. 2008;33(3):345-9. doi: 10.1177/1753193408091351.
  • 16. Yaseen G, Qureshi KK, Hussain A. Results of mini external fixator in metacarpal and phalangeal fractures: Mini External Fixator in Metacarpal And Phalangeal Fractures. Pak Armed Forces Med J. 2016;66(5):715-19.
  • 17. Thakur A. Operative management of metacarpal and phalangeal fractures. J Med Educ Res. 2008; 10(1):1-9.
  • 18. Li WJ, Tian W, Tian GL, Chen SL, Zhang CQ, Xue YH, et al. Management of intra-articular fracture of the fingers via mini external fixator combined with limited internal fixation. Chin Med J (Engl). 2009;122(21):2616-9. PMID: 19951580.
  • 19. Drenth DJ, Klasen HJ. External fixation for phalangeal and metacarpal fractures. J Bone Joint Surg Br. 1998;80(2):227-30. doi: 10.1302/0301-620x.80b2.8131
  • 20. Dailiana Z, Agorastakis D, Varitimidis S, et al. Use of a mini-external fixator for the treatment of hand fractures. J Hand Surg Am. 2009;34(4):630-636. doi:10.1016/j.jhsa.2008.12.017.
  • 21. Margić K. External fixation of closed metacarpal and phalangeal fractures of digits. A prospective study of one hundred consecutive patients. J Hand Surg Br. 2006;31(1):30-40. doi: 10.1016/j.jhsb.2005.09.013.
  • 22. Ahmad S, Gupta T, Ansari S, Jain A, Barik S, Singh V. Intramedullary Crossed K-wire Fixation for the Hand Fractures is a Useful Treatment Modality: A Prospective Observational Study. Strategies Trauma Limb Reconstr. 2022;17(2):74-80. doi: 10.5005/jp-journals-10080-1556.
  • 23. Gupta R, Singh R, Siwach R, Sangwan S, Magu NK, Diwan R. Evaluation of surgical stabilization of metacarpal and phalangeal fractures of hand. Indian J Orthop. 2007;41(3):224-9. doi: 10.4103/0019-5413.33687.
  • 24. El-Shaera AF, Shams El-Deenb AF, El-Deen Abu Husseinb AS , et al. Results of management of recent fractures of phalanges of the hand by a mini external fixator. Menoufi a Medical Journal 2015, 28:965–70. doi: 10.4103/1110-2098.173689
  • 25. Tank PM and Patel NB. Simple low cost static external fixators for phalangeal fractures of hand. Int J Orthop Sci. 2018;4(1):714-20. doi: 10.22271/ortho.2018.v4.i1k.103
There are 25 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Research Article
Authors

Gözde Kirgın 0009-0006-9090-0177

Tufan Kaleli 0000-0003-4853-213X

Publication Date April 1, 2025
Submission Date September 30, 2024
Acceptance Date February 2, 2025
Published in Issue Year 2025 Volume: 9 Issue: 1

Cite

Vancouver Kirgın G, Kaleli T. External Fixator Applıcatıons in Phalanx and Metacarpal Bone Fractures. Acta Med. Alanya. 2025;9(1):10-8.

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