The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

A Novel Mini External Fixation Technique versus Percutaneous Pinning in the Treatment of Phalanx Fracture in Hand

Document Type : RESEARCH PAPER

Authors
Parviz Ahangar 1
Mostafa Shahrezaee 1
Reza Shahryar kamrani 2
Shamim Fattah Hesari 1
Seyed Shahabeddin Banihashemian 3
Soosan Alimohammadzadeh Taher 1
1 Department of Orthopaedic and Trauma Surgery, Imam Reza Hospital, Aja University of Medical Sciences, Tehran, Iran
2 Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Rheumatology, Imam Reza Hospital, Aja University of Medical Sciences, Tehran, Iran
10.22038/abjs.2024.74859.3484
Abstract
Objectives: Hand fracture is one of the most common fractures in the skeletal system. The present 
study aimed to introduce a newly designed external fixator and assess the results of treatment of 
patients with unstable and complex fractures of the proximal and middle phalanges of the fingers with 
two treatment methods: "fixation with percutaneous pins (PCP) + splint" and "fixation with mini external 
fixator.
Methods: In this prospective cohort study, patients with acute unstable and complex fractures of the proximal and 
middle phalanges of the second to fifth fingers were treated with two treatment methods, including "fixation with PCP 
+ splint" and "the use of mini external fixator." At the final follow-up visit, union, pain, function, finger range of motion 
(ROM), and possible complications were considered.
Results: Among 52 patients included in the study, 33 cases were treated with a mini external fixator, and 19 patients 
underwent fixation with PCP and splint. All patients in both groups had a union, and none of them complained of 
pain during the final visit. Functional outcomes were good, and there was no statistically significant difference 
between the two groups. The mini external fixator group had a significantly greater finger ROM (P=0.012), with a 
lower number of physiotherapy sessions (P=0.018). Moreover, patients returned to work more promptly (P=0.012).
Conclusion: The treatment of unstable finger fractures with a mini external fixator had three advantages: the 
possibility of early initiation of finger movement and improvement of finger ROM, the need for fewer physical therapy 
sessions, and early return to work. It can be an effective treatment option for unstable and complex finger fractures.
 Level of evidence: II
Keywords
Finger fractures
Hand injury
Mini external fixator
Pin fixation
Subjects
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The Archives of Bone and Joint Surgery
Volume 13, Issue 7
July 2025
Pages 414-419

  • Receive Date 28 October 2023
  • Revise Date 06 October 2024
  • Accept Date 07 October 2024