Complex finger fractures treated with alternative external fixators
Three cases in a hospital in the province of Buenos Aires in 2024
Keywords:
Traumatismos de los Dedos, Fracturas Óseas, Fracturas Abiertas, Fracturas Conminutas, Fracturas Cerradas, Fijadores ExternosAbstract
T
Introduction: Complex finger fractures can cause significant
disabilities if not treated properly, as they often involve multiple
bone fragments, significant displacement, and joint involvement.
This study aims to describe the clinical and functional outcomes
of patients with complex finger fractures treated with alternative
external fixators, based on the presentation of three clinical cases
treated at the Traumatology Service of Dr. Carlos Bocalandro
Hospital in Loma Hermosa, Tres de Febrero, province of Buenos
Aires, in 2024. Methods: Qualitative research (case series) with a
descriptive, observational, and documentary approach based on
clinical records. Sources of information: data were collected from
the review of three medical records of adult patients, direct
observations, and clinical progress notes. Results: The article
describes the use of alternative external fixators in the treatment
of three adults with complex finger fractures treated in the
Orthopedics and Traumatology Service. The cases include
comminuted and open fractures, treated with this method. The
surgical technique involved the precise placement of Kirschner
wires, using mono- or bilateral constructs joined together with
K-10 tubes filled with polymethylmethacrylate cement to bond
them together and achieve the necessary construct rigidity. This
technique demonstrated adequate reduction and stabilization,
facilitating early mobilization and reducing the risk of joint
stiffness. This approach resulted in satisfactory functional
recovery and a low complication rate. However, its placement
requires careful planning of the construct positioning and does
not necessarily require specific surgeon experience, making it a
less invasive technique. Conclusion: The interventions included
various immobilization and external fixation techniques, with
results ranging from complete and successful recovery to partial
recovery due to complications and lack of patient follow-up.
Alternative external fixators represent an effective and safe
option for the treatment of complex finger fractures in adults,
although further studies with larger sample sizes and
biomechanical evaluation are needed to confirm their usefulness
Downloads
References
1. Wolfe SW, Pederson WC, Hotchkiss RN, Kozin SH, Cohen MS. Green's operative hand surgery. 7ª ed. Filadelfia (PA): Elsevier; 2016.
2. Swanson AB, Hagert CG, Swanson GD. Evaluation of impairment of hand function. J Hand Surg Am [Internet]. 1983 [Acceso mar. 2025];8(5 Pt 2):709-22. Disponible en: https://www.jhandsurg.org/article/S0363-5023(83)80253-6/abstract
3. Glickel SZ, Barron OA, Eaton RG. Dislocations and ligament injuries in the digits. En: Green DP, editor. Green’s operative hand surgery. 5ª ed [Internet]. Filadelfia (PA): Elsevier; 2005 [Acceso mar. 2025]. p. 621-57. Disponible en: https://doctorlib.org/surgery/operative-techniques-orthopaedic-surgery/277.html
4. Hudak PL, Amadio PC, Bombarider C, Upper Extremity Collaborative Group (UECG). Development of an upper extremity outcome measure: the DASH (Disabilities of the Arm, Shoulder and Hand). Am J Ind Med [Internet]. 1996 [Acceso mar. 2025];29(6): 602-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/8773720/
5. Huskisson EC. Measurement of pain. The Lancet [Internet]. 1974 [Acceso mar. 2025];2(7889):1127-31. Disponible en: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(74)90884-8/fulltext
6. Buenos Aires. Poder Legislativo. Ley 15.462: Regulación de la investigación en salud y creación de la Comisión Conjunta de Investigaciones en Salud (CCIS) [Internet]. 2023 Oct 24 [Acceso mar. 2025]; 29.615. Disponible en: https://normas.gba.gob.ar/ar-b/ley/2023/15462/393638
7. World Medical Association. Declaration of Helsinki: Ethical principles for medical research involving human participants. JAMA [Internet]. 2025 [Acceso mar. 2025];333(1):71-4. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/2825290
8. Thomas RK, Gaheer RS, Ferdinand RD. A simple external fixator for complex finger fractures. Acta Orthop Belg [Internet]. 2008 [Acceso mar. 2025]; 74(1):109-13. Disponible en: https://pubmed.ncbi.nlm.nih.gov/18411610/
9. Shehadi SI. External fixation of metacarpal and phalangeal fractures. J Hand Surg Am [Internet]. 1991 [Acceso mar. 2025]; 16(3):544-50. Disponible en: https://www.jhandsurg.org/article/0363-5023(91)90030-F/abstract
10. Ugwonali OFC, Jupiter JB. Mini external fixation in the hand. Tech Hand Up Extrem Surg [Internet]. 2006 [Acceso mar. 2025];10(3):187-96. Disponible en: https://journals.lww.com/techhandsurg/abstract/2006/09000/mini_external_fixation_in_the_hand.13.aspx
11. De Kesel R, Burny F, Schuind F. Mini external fixation for hand fractures and dislocations: the current state of the art. Hand Clin [Internet]. 2006 [Acceso mar. 2025];22(3):307-15. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S074907120600028X?via%3Dihub
12. McCulley SJ, Hasting C. External fixator for the hand: a quick, cheap and effective method. J R Coll Surg Edinb [Internet]. 1999 [Acceso mar. 2025];44(2):99-102. Disponible en: https://pubmed.ncbi.nlm.nih.gov/10230205/
13. Crockett DJ. Rigid fixation of bones of the hand using K wires bonded with acrylic resin. Hand [Internet]. 1974 [Acceso mar. 2025];6(1):106-7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/4825394/
14. Li W, Tian W, Tian G, Chen S, Zhang C, Xue Y, Li Z, Zhu Y. Management of intra-articular fracture of the fingers via mini external fixator combined with limited internal fixation. Chin Med J [Internet]. 2009 [Acceso mar. 2025];122(21):2616-9. Disponible en: https://journals.lww.com/cmj/fulltext/2009/11010/management_of_intra_articular_fracture_of_the.18.aspx
15. Dailiana Z, Agorastakis D, Varitimidis S, Bargiotas K, Roidis N, Malizos KN. Use of a mini-external fixator for the treatment of hand fractures. J Hand Surg Am [Internet]. 2009 [Acceso mar. 2025];34(4):630-6. Disponible en: https://www.jhandsurg.org/article/S0363-5023(08)01137-4/abstract
Downloads
Published
Data Availability Statement
ARK CAYCIT:
Issue
Section
License
Copyright (c) 2026 Ernesto Bertoni, Jorge Luis Soutullo, Marcos Maiorano, Héctor Adrián Ávila Salinas, Aníbal Javier Rondán, Juan Celestino Valdés Rojas, Claudio Pedra, María Gabriela Bonta, Karen Poccia, Federico Russo, Valeria Ochoa
This work is licensed under a Creative Commons Attribution 4.0 International License.
Los/as autores/as prestan su conformidad para ceder los derechos de copia (copyright) de sus manuscritos a la Revista, en la forma de cesión no exclusiva de derechos. Los/as autores/as conservan los derechos sobre sus trabajos.
