A STUDY ON STABILIZATION OF COMPOUND SMALL BONE FRACTURES OF HAND AND FOOT WITH JESS FIXATOR

Abstract

Background : The fractures of small bones of hand and foot should not be more complicated and damaging compared to the damage caused by the injury itself. The goal is to achieve good stability of the bone and joint, which allows early motion without resulting in the residual instability and malunion. These fractures of small bones of hand and foot can be treated with an external xator that allows fracture reduction attaining normal alignment. we took up the study with an aim to access the overall function and complications in treating open small bones of hand and foot with JESS xator. Methods: We performed a prospective study on 20 adult patients (14 males and 6 females) with small bone fractures of hand and foot, who attended outpatient or admitted in inpatient in the department of orthopaedics, government general hospital, Kakinada from October 2017 to august 2019. We excluded closed fractures and severely crushed fractures with neurovascular and tendon injuries. Results: 5 Results are recorded based on Duncan et al. criteria for ngers. For toes, the results are graded based on a total active range of movements. Most of the cases (n=17) showed radiological union within 12 weeks. Two cases took more than 20 weeks to heal. Whatever be the radiological union, the frame is removed mostly by 15 days postop (n=18) and by a maximum period of 21 days (n=6). the results are found to be excellent in 40% of cases, good in 44% cases, fair in 8% and poor results are seen in 8% cases. We had extensor lag as the most common complication (60%, n=15), 2 cases with malunion (8%) and one case (4%) with supercial infection. Conclusion: Hand serves many functions of precise movement, grip, grasp, touch etc. though these are small bones their fracture are not to be neglected and should be managed with utmost care. Jess is simple to operate, cheap, easily available, and has less complication rate. It makes the postoperative management simple and effective. It allows early mobilization, which prevents joint stiffness. Removing the frame at end of second postoperative week allows good functional results and doesn't compromise the stability of fracture.