ABSTRACT
BACKGROUND: The surgical aims in managing displaced intra-articular fractures of the base of the middle phalanx include early joint reduction, maintaining congruence and early mobilization. Achieving this can be a challenge. However dynamic external fixators offer a solution. The study aim was to evaluate the use and outcomes of the Ligamentotaxor external fixator in patients with such injuries. METHODS: A total of 12 patients were managed with this device and outcomes were assessed. All patients reached clinical and radiological union. RESULTS: An average range of movement to the proximal interphalangeal joint of 63° was noted along with an average end of care-cycle quick-DASH score of 9.1. Two patients developed pin-site infections. CONCLUSIONS: The outcomes seen support the use of the Ligamentotaxor in the management of middle phalanx intra-articular fractures. It is simple to apply, potentially avoids the secondary complications of open reduction and gives reproducible results. However judicious patient selection is advised.
Subject(s)
External Fixators , Finger Injuries/surgery , Finger Joint/surgery , Fracture Fixation/instrumentation , Intra-Articular Fractures/surgery , Range of Motion, Articular/physiology , Adult , Equipment Design , Female , Finger Injuries/physiopathology , Finger Joint/physiopathology , Follow-Up Studies , Humans , Intra-Articular Fractures/physiopathology , Male , Prospective StudiesABSTRACT
Partial width tendon grafts are commonly used in upper limb reconstructive surgery. Different techniques are described to harvest the graft including a "cheese wire" technique to split the tendon along its fibres with a filament. However no study has looked at the best material for this purpose. Fresh flexor tendons from pigs' trotters were used to analyse the splitting qualities of 11 different suture materials. The qualities assessed were: whether the suture material was successful in splitting the tendon, the average force required to split the tendon and the resulting quality of the spilt tendon graft. Whilst wire sutures produced a high quality of graft, they were awkward to use as they necessitated handling with a holder due to the higher forces required to split the tendon. Fibrewire provided the best result with respect to graft quality and ease of method as it combined the cutting strength of wire with the handling characteristics of a braided suture.
