gms | German Medical Science

Objectives/Interrogation: Recently, there are plenty of commercial external fixators for hand fractures. However, they are difficult to adjust after application. The ideal external fixator in hand is low profile and adequately rigid for early mobilization, and easy to apply and modify. We developed adjustable linking wire type of external fixator that enable to use all type of fractures and possess several unique features, including exclusive use in hand fractures and on-site, on-demand construction. The aim of this study is to demonstrate its ease of application, low profile, and simple design as well as the possibility to apply it as a static as well as a dynamic fixator.

Methods: The Ichi-Fixator (Neomedical, Saitama, Japan) set includes three different size metal clamps and wires (1.2, 1.5, 1.8mm diameter, two type of each in smooth needle and partial thread screw). For the use of distraction type of external fixator, the basic construct of the Ichi-fixator is made of two wires bent into a wire frame and secured together with two special adjustable metal clamps fixation with small two screws. Because of the adjustable function of small screws inside of fixator, the Ichi-Fixator enable to modulate under fluoroscopic inspection such as a static or distraction fixator for simple or communited diaphysis fractures of all phalanges and all metacarpal, and all interphalangeal joints and the thumb metacarpal joint as well as a dynamic fixator.

Results and Conclusions: Twenty-two patients in a variety of fracture patterns were treated with Ichi-Fixator. The fixator was rigid and maintained reduction in all fractures. The procedure lasted 20 to 45 minutes. Ichi-Fixator were removed in a mean period of 6 weeks, and follow-up was 6 to 15 months. Averaged the QDASH score was decreased from 78.69 to 12.35 and the VAS score was decreased from 6.75 to 1.44. The grip strength and total active motion were 84.9% and 76.7%, respectively, compared with the contralateral side. There was no wire site infection and no non-unions. There were no pain and returned to all their previous activities without discomfort. The findings of this case series demonstrated that Ichi-Fixator can be considered for all hand fractures requiring surgical treatment, and especially for comminuted fractures. Ichi-fixator enables enhanced security of fixation, facilitates postoperative mobilization, and may allow an immediate return to work.