JESS fixator for Metacarpal and Phalangeal fracture

Abstract

The fractures of metacarpal and phalanges of the hand are the most common injury encountered inemergency department. Most often these injuries are neglected as minor injuries and later on developsa functional limit of the hand. Joshi’s external stabilizing system (JESS) fixator based on the principleof ligamentotaxis, stabilize the unstable and intraarticular fractures of metacarpal and phalangeal andalso provides an environment for rapid soft tissue healing without further damaging the microvascularcirculation. The study includes total number of 38 patients with a diagnosis of fracture of Metacarpal andphalanx of hand admitted in Nepal Medical college and Teaching Hospital who were treated with JESSfixator. The functional outcome after the removal of JESS fixator was assessed by calculating AmericanSociety for Surgery of Hand and Total Active flexion (ASSH TAF). Among the 38 patients, all fractures wentto union with an average union period of 6 weeks. The mean period of treatment for metacarpal fractureswas12 weeks and for phalangeal fractures 16 weeks by which time patients regained full functional activityof hand and returned back to their respective works. The functional outcome assessed by ASSH-TAF scorewas excellent in 28 patients, good in 10 patients and none of them had a poor result. The complication wasseen in 9(23.68%) cases, superficial pin tract infection and K Wire Loosening. JESS fixator is cheap, easilyavailable and less technically demanding, provides with an effective treatment for the metacarpal andphalanges fracture, as it provides adequate stability that allows early rehabilitation with soft tissue careand has got a good functional outcome

Keywords : American Society for Surgery ofHand and Total Active flexion(ASSH TAF), Fixator, Joshi’s externalstabilizing system (JESS), Metacarpaland Phalangeal fracture