gms | German Medical Science

Purpose:

• Present a bigger series (83 cases) of the new technique for fixation of the metacarpal and proximal phalangeal extra articular fractures.
• Show that Hybrid Dynamic Minifix ® consist of a combination of intramedullary nailing and external fixation system.
• Demonstrate that a hardware stable but not rigid fixation is achived, then permits immediate motion without cast inmobilization.
• Enlarge the indications and present some modifications to the original technique presented by the former author in the last IFSSH 2016 congress.

Methods: Two Hand Unit-Teaching Hospitals (2015-2018). Just One-Senior Hand Surgeon. Retrospective study of 83 metacarpal and phalangeal fractures. MTC I-V (n=54) - Proximal Phalanx I-V (n=29). Inclusion criteria: coronal plane angulation >10°, sagital plane angulation >20°, pseudoclowing, clinical rotation deformity, not open fracture, extra-articular, <15 days.

Results and Conclusions: Type of bone:5MTC (30%), 1MTC (20%) and 5 proximal phalanx (12%). Withdrawal of Minifix performed up 4 weeks in 90.3% of cases. Return to work 77.4% of cases less than a month after surgery, 22.6% between 1 to 2 months. Basic disabilities only 9.7% of patients were over 15 days with basic daily disabilities. Pain after surgery only 6.5% had high pain more than 3 days. Satisfaction: all patients were very satisfied. Regarding surgical complications just 6% had k-wire inflammation well-controlled by antibiotics. There were any cases of non union, delay in consolidation or sympathetic nerve dystrophy. Just one case had rotational deformity and only 5 cases had relative decreased of range of motion. We also apply this technique for correction of non-unions, segmental bone fractures, mal rotations deformities with successful results.

Hybrido Dynamic Minifix (HDM®) technique represents a highly reproducible simple method, inexpensive, with successful results and a low rate of complications.

The time of return to daily activities or work is reduced due to immediate mobility, thus stimulating the consolidation and avoiding rigidity.

Modification technique using the non-injuried and parallel metacarpal bone showed the same security and success for the consolidation and represents an alternative to inset two k-wires for the same circular bone.

Hybrido Dynamic Minifix (HDM®) is presented as a new treatment option for percutaneous extra articular fractures of the proximal phalanx and metacarpals avoiding all risks associated with open surgery or prolonged cast immobilization