Light syringe barrel (external fixator) for phalangeal and metacarpal fractures: A case series

Background: External fixation is a well-established technique for management of displaced metacarpal and phalangeal fractures. External fixation can achieve adequate fixation with relatively low complications. Methods: This is a study of 45 patients (48 digits) with phalangeal and metacarpal fractures that were managed using a simple light external fixator system. Eighteen patients had a comminuted fracture pattern, sixteen had a transverse, ten had an oblique, and two had a spiral fracture pattern. Radiographic outcomes were reviewed on a regular basis after surgery. Functional outcomes were assessed using total active motion of the digit and plotted using the American Society for Surgery of the Hand (ASSH) score. Results: All the patients achieved radiographic fracture union at a mean duration of 6 wk (average 4-8 wk). As for functional outcomes according to the ASSH score, excellent results were achieved in 34, good results in three, fair results in nine, and poor in two. One patient had redisplacement that required revision internal fixation. Fair and poor results were found mainly in elderly and uncooperative patients due to noncompliance with postoperative hand mobility exercises. Conclusions: The light external fixator system provided a simple, easy, cheap, and adequate technique for management of displaced metacarpal and phalangeal fractures, with good radiographic and clinical outcomes. Strict adherence to hand motion exercises is mandatory to achieve favorable outcomes. Level of Evidence: Level IV.