JESS IN THE TREATMENT OF HAND AND FOOT INJURIES –AN USEFUL ARSENAL AS DAY CARE MANAGEMENT TOOL.

Abstract

BACKGROUND: Small bone fractures of hand and feet are very common in a developing country like India and consist of 15% to 20% among all patients presenting at trauma centre and orthopaedic opds. Small bone fractures such as fractures of phalanx or metacarpals are often tend to be overlooked and of deemed as less serious in nature. However even a small deformity or disability of hand and feet can hamper the functional and psychological wellbeing of a person in long term. The purpose of this study is to evaluate the functional outcome and complications associated with application principles of JESS (Joshi's External Stabilization System) xation in phalanx, metacarpal and metatarsals and their management as a day care procedure. MATERIAL AND METHODS: This prospective observational study was done over a period of 1 year on 21 patients for injuries of metacarpal, phalanx and metatarsals and followed up for a minimum period of 3 months post frame removal. RESULTS: Young patients constituted almost 60% of the study population. RTA, assault and industrial / factory setup injury is most prevalent mode of injury. Over all closed injury patients had better functional outcome than open fractures. CONCLUSION: JESS is a versatile, easy to use system that can be applied at a very average set up. Optimum management of comminuted, open and unstable small bone fractures of hand and feet is possible with JESS. We advocate more extensive use of such a low cost and versatile system in Indian setup where cost of treatment is a major factor for going forward with a treatment option.