PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Research Article

Volume 1 Issue 1

Comparison between K-wiring Versus K-wiring with External Fixation (JESS) in Compound Intra-articular and juxta-articular Metacarpal and Phalangeal Fractures of the Hand: A Randomized Control Study

Bishal Kumar Deka* and Hafizur Rahman

January 10, 2023


Background: The fracture of the hand results in significant disability and leads to long term negative functional sequelae including loss of ability to work and live at pre injury level. Most of these fractures can be treated conservatively. However, conservative treatment has poor outcome in unstable, intra-articular and compound fractures, making operative means a necessity for such cases. Materials and Methods: A prospective randomized control study was undertaken in our institute consisting of 100 cases of intra-articular and juxta-articular fractures of the small long bones of the hand who were treated with either simple K-wiring versus K-wiring with external fixation over a period of 12 months from January till December 2020. The cases were evaluated for functional outcome at the end of 12 months of follow up. Results: 100 cases with 129 fractures of the metacarpals and phalanges of hand were randomized and treated with either K-wires or Joshi’s External Stabilisation System (JESS) fixator. The mean age of the cases was 31-40 years with male predominance. Motor vehicle accidents were the commonest cause of trauma. The operative time for JESS fixation was longer than K-wiring alone, which was statistically significant. Functional outcome was assessed based on Modified Mayo Wrist Score and ASSH-TAF scores. At the end of 12 months, JESS fixation had statistically and functionally better results. Discussion: The authors advocate the early management of hand fractures with JESS Fixation compared to K-wiring alone. The outcomes were also dependent on the age, gender and compliance of the patients.

Keyword: Hand fractures; K-wire; JESS