Jess Fixator for Metacarpal and Phalangeal Fracture

Abstract

 The fractures of metacarpal and phalanges of the hand are the most common injury encountered in emergency department. Most often these injuries are neglected as minor injuries and later on develops a functional limit of the hand. Joshi’s external stabilizing system (JESS) fixator based on the principle of ligamentotaxis, stabilize the unstable and intraarticular fractures of metacarpal and phalangeal and also provides an environment for rapid soft tissue healing without further damaging the microvascular circulation. The study includes total number of 38 patients with a diagnosis of fracture of Metacarpal and phalanx of hand admitted in Nepal Medical college and Teaching Hospital who were treated with JESS fixator. The functional outcome after the removal of JESS fixator was assessed by calculating American Society for Surgery of Hand and Total Active flexion (ASSH TAF). Among the 38 patients, all fractures went to union with an average union period of 6 weeks. The mean period of treatment for metacarpal fractures was12 weeks and for phalangeal fractures 16 weeks by which time patients regained full functional activity of hand and returned back to their respective works. The functional outcome assessed by ASSH-TAF score was excellent in 28 patients, good in 10 patients and none of them had a poor result. The complication was seen in 9(23.68%) cases, superficial pin tract infection and K Wire Loosening. JESS fixator is cheap, easily available and less technically demanding, provides with an effective treatment for the metacarpal and phalanges fracture, as it provides adequate stability that allows early rehabilitation with soft tissue care and has got a good functional outcome