Functional and Radiological Outcomes of Metacarpal and Phalangeal Fractures using Intramedullary K-Wires and Joshi’s External Stabilization System

Objectives: Hand injuries are quite common and affect 15% of people who go to the emergency room. Metacarpals and phalanges are the two bones that fracture most frequently, with a prevalence of between 10 and 15%. The use of intramedullary K-wires in conjunction with an external fixation system, like Joshi's External Stabilization System (JESS), is optional. The functionality of JESS is based on the ligamentotaxis theory. Material and Methods: This prospective study was conducted in the Department of Orthopedics, Sher-I- Kashmir Institute of Medical Sciences, Bemina, on 40 patients with metacarpal and phalangeal fractures managed by Kirschner wires (K- wires) and JESS for a period of 2 years starting from July 2019. The collected data were analyzed with the help of the Statistical Package for the Social Sciences (SPSS), version 21. Results: In present study the most of the study subjects were in the age group of 28-37 years (40%), there was male predominance with the male to female ratio 2.5:1, majority of the study subjects were laborer (38%), right side was involved most commonly (62%), the major cause of fracture was road traffic accident (58%) and most (96%) of the study subjects were operated within 24 hours of the injury. Conclusion: The study concluded that augmentation of JESS over intramedullary K- wires provides a stable skeletal environment with early tissue healing and immediate active and passive mobilization of the uninjured adjacent joints, and also provides rotational stability as the majority of the study subjects achieved excellent functional outcomes.