Fractured phalanges are frequently caused by occupational accidents leading to complications and disability. The complications become much more grave when these fractures become open.
Different treatment options have been employed so far to treat such fractures. These range from surgical toileting and Plaster of Paris immobilization, K-wire fixation to modern highly expensive external fixator. Today the modern highly expensive external fixator is the leading modality of treatment for such open phalanx fractures.
In a poor country like Bangladesh, most of the patients can not afford such expensive implants. The purpose of the study is to analyze the results of management of open phalanx fracture by chip, available indigenous mini external fixator. The reason of my research is to establish indigenous external fixator as a treatment option for open phalanx fracture in The National Institute of Traumatology and Orthopedic Rehabilitation (NITOR) Dhaka, Bangladesh.
Table of Contents
1. Introduction
2. Hypothesis
3. Objectives
4. Review of literature
4.1 Related works
4.2 Historical Review
4.3 External Fixation component Mechanics
4.4 Bio-Mechanics of External Fixator:
4.5 Mechanism of Fracture Healing following external fixation
4.6 Pathophysiology of Phalanx fracture
4.7 Fracture of Proximal and Middle phalanges
4.8 Classification of metacarpal and phalangeal bone Fracture
4.9 Principles of management of open fracture of hand
Goal of Treatment:
Initial Evaluation
Evaluation of the fracture on X-ray
Rehabilitation
5. Patients and Methods
6. OBSERVATION AND RESULT
7. Discussion
8. SUMMARY AND CONCLUSION
9. BIBLIOGRAPHY
CASE REPORT-1
CASE REPORT-2
CASE REPORT-3
CASE REPORT-4
Research Objectives and Focus Areas
This study evaluates the clinical effectiveness of using a mini-external fixator as a management strategy for patients suffering from open, unstable phalanx fractures, specifically targeting the improvement of functional outcomes in resource-constrained medical environments.
- Assessment of the mini-external fixator's impact on overall hand function.
- Determination of the post-treatment range of motion for affected fingers.
- Evaluation of the time required for successful clinical and radiological fracture healing.
- Identification of common complications and procedural limitations.
- Analysis of patient demographics and injury patterns in orthopaedic trauma cases.
Excerpt from the Book
4.4 BIO-MECHANICS OF EXTERNAL FIXATOR:
Cliinical and experimental evidence has shown that with the use of AO tubular components, one or two plane unilateral fixator can be made stiff enough to accommodate most injury condition (Behrens & Johnson 1985).
Small bone external fixator comply to the same rigidity principles as large bone systems, their stiffness depending on the number of pins/ segment pin spacing, pin direction, wire diameter, thread characteristics, wire length, type of pin/ rod fixation and connection bar-configuration. Currently there are numerous commercially available external hand fixators. Unfortunately, the bio mechanical requirement during various application in hand surgery have not been clearly established, and therefore, the selection of a particular model and a specific configuration is often a matter of personal preference. An “ideal” degree of osseous stability for managing each clinical situation treated with external fixation is ill defined. Any fixation technique should attempt to match the bio-mechanical requirement of the clinical situation with stability of the overall construct. The following characteristics have been shown to increase the
Summary of Chapters
1. Introduction: Provides background on hand anatomy and the prevalence of hand injuries, highlighting the need for effective treatment of open phalanx fractures in Bangladesh.
2. Hypothesis: Posits that the mini-external fixator is an effective method for managing open, unstable fractures of the phalanx.
3. Objectives: Outlines the goal to evaluate the effectiveness of the mini-external fixator regarding hand function, range of motion, and healing time.
4. Review of literature: Examines historical and contemporary methods of external fixation, biomechanical principles, fracture healing mechanisms, and management strategies for hand injuries.
5. Patients and Methods: Details the quasi-experimental study design, population, and procedures used for applying the mini-external fixator and subsequent clinical follow-up.
6. OBSERVATION AND RESULT: Presents findings from the clinical study, including patient demographics, fracture classifications, and clinical outcomes measured by TAM scores.
7. Discussion: Interprets the study results in the context of global findings, noting the success of the fixator in a resource-limited setting while acknowledging patient compliance challenges.
8. SUMMARY AND CONCLUSION: Concludes that the mini-external fixator is a cost-effective and efficient method for treating open phalanx fractures.
9. BIBLIOGRAPHY: Lists the academic sources used to support the review of literature and clinical methodology.
Keywords
Phalanx fracture, External Fixator, Orthopaedics, Hand surgery, Biomechanics, Fracture healing, Traumatology, Mini-external fixator, Hand function, Clinical outcomes, Open fractures, Bone stabilization, Physiotherapy, NITOR, Surgery
Frequently Asked Questions
What is the primary focus of this thesis?
The thesis focuses on the clinical evaluation of using an indigenous mini-external fixator to manage open, unstable phalanx fractures within the orthopaedic department of NITOR.
What are the central themes discussed in this study?
The study centers on the biomechanics of fixation, the importance of early mobilization in hand injuries, and the effectiveness of mini-external fixators in a developing country.
What is the core research objective?
The primary objective is to determine the effectiveness of the mini-external fixator in restoring hand function and achieving fracture union in patients with open phalanx fractures.
What scientific methods were employed?
The researcher conducted a quasi-experimental clinical trial utilizing purposive sampling and analyzed gathered data using SPSS software to assess range of motion and healing progression.
What does the main body of the work cover?
The main body details the literature review on fracture mechanics, the systematic clinical and operative methodology, and the subsequent analysis of results through various tables and observations.
Which keywords best describe this research?
Key terms include phalanx fracture, external fixation, biomechanics, hand surgery, and clinical outcome evaluation.
Why are mini-external fixators considered advantageous in this study?
They are described as cost-effective, easy to apply, and instrumental in allowing early mobilization of joints, which reduces long-term stiffness compared to conventional splinting.
What role does the "Total Active Range of Motion" (TAM) play in this study?
TAM is the primary metric used to categorize the final functional outcome (Excellent, Good, Fair, Poor) for patients post-operation.
How does the researcher handle the problem of unstable open fractures?
The researcher emphasizes that surgical toileting followed by stable external fixation provides a rigid structure that facilitates wound care and early rehabilitation.
What were the most common complications noted during the study?
The most commonly reported complications included superficial pin tract infections, which were addressed with appropriate treatment, and rare instances of stiffness or non-union.
- Arbeit zitieren
- Dr. Rezwanul Bari (Autor:in), 2008, Mini External Fixator for Open Unstable Phalanx Fracture. Evaluation of Results, München, GRIN Verlag, https://www.grin.com/document/307210
