Yamamoto Y, Ichihara S, Suzuki M, Hara A, Hidalgo Díaz J J, Maruyama Y, Kaneko K
Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.
Hand Surgery Center, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan.
Hand Surg Rehabil. 2019 Oct;38(5):302-306. doi: 10.1016/j.hansur.2019.07.011. Epub 2019 Aug 6.
External fixators are an effective treatment option for comminuted or unstable phalangeal fractures. We developed a new linked-wire type of external fixator (the Ichi-Fixator) for finger phalangeal fractures, which enables fine adjustment of the fixation under fluoroscopy guidance either in a static way or with distraction through small screws inside the fixator. This technique was designed to improve on the stability and rigidity of conventional percutaneous Kirchner wire fixation. We assessed the effectiveness of the fixator through 12 cases of open or percutaneous fixation in comminuted or unstable phalangeal fractures. All patients were examined for postoperative complications, functional recovery, pain on visual analog scale (VAS), and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score at the final follow-up visit. Patients could perform all routine activities with normal grip strength and a full range of hand motion without pain after treatment. This treatment, which reduces the postoperative discomfort and may allow an immediate return to work, will clearly boost patient satisfaction. Linked-wire type external fixation enhances the security of fixation, facilitates postoperative mobilization, and may allow an immediate return to work.
外固定器是治疗粉碎性或不稳定指骨骨折的一种有效选择。我们开发了一种新型的用于手指指骨骨折的连丝式外固定器(Ichi-Fixator),它能够在透视引导下以静态方式或通过固定器内部的小螺钉进行牵张,实现固定的精细调整。该技术旨在提高传统经皮克氏针固定的稳定性和刚性。我们通过12例开放性或经皮固定的粉碎性或不稳定指骨骨折病例评估了该固定器的有效性。在末次随访时,对所有患者进行术后并发症、功能恢复、视觉模拟评分法(VAS)疼痛评分以及上肢、肩部和手部快速残疾评定量表(QuickDASH)评分检查。治疗后,患者能够以正常握力进行所有日常活动,手部活动范围正常且无疼痛。这种治疗方法减少了术后不适,可能允许患者立即恢复工作,显然会提高患者满意度。连丝式外固定增强了固定的安全性,便于术后活动,并可能允许患者立即恢复工作。