Role of dynamic external fixator in the management of fractures of distal end of radius.

The intra-articular fracture of radius has been an enigma for orthopaedic surgeons since time immemorial. It is a dilemma as to when to use the fixator, when to mobilise after fixator or simply treat it by conservative means. Numerous fixators are in vogue depending on the preference of the surgeon--in the present prospective study the results of dynamic external fixator--which, based on the principle of ligamentotaxis, were evaluated over a 3-year period and the results showed that although excellent radiological results were seen in 90% of the cases yet only 75% of the cases had a excellent functional result.

Joshi External Stabilising System (JESS) in proximal interphalangeal joint (PIP) contractures in leprosy.

The authors present their experience in the use of the JESS (Joshi External Stabilising System) for correction of proximal interphalangeal joint (PIP joint) contracture deformity in 68 fingers. The use of the JESS has made this surgery easier, faster in releasing contractures and it has given better correction than the methods so far used by the same authors, like capsulotomy, local flaps and free skin grafting. The procedure is simple and has no serious side effects; it can be repeated if need be. The JESS is easy to apply, economical, reliable, reusable, well accepted by the patient. Compared to the other distractors made in USA and Europe, the JESS has an added advantage in that it costs so very much less (US $5-10), that our leprosy hospitals can afford it. In our patients, we have achieved full extension in 75% and good extension in 10.3% of the cases. These figures are much better than what was possible, in the past, with local flaps and free skin grafting. With those procedures we had excellent results in only 53% of the cases and poor result in 28%.