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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Early Active Vector Adjustable Skin Traction (EAVAST) for phalangeal fractures of the hand

Meeting Abstract

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  • presenting/speaker Jason Lam - NSW Health, Sydney University, Sydney, Australia
  • Jason Fairclough - NSW Health, Sydney University, Sydney, Australia
  • Jason Diab - NSW Health, Sydney University, Sydney, Australia
  • Stephen Wood - NSW Health, Sydney University, Sydney, Australia
  • Queenie Chan - NSW Health, Sydney University, Sydney, Australia
  • Michael Dowd - NSW Health, Sydney University, Sydney, Australia

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1797

doi: 10.3205/19ifssh0711, urn:nbn:de:0183-19ifssh07111

Published: February 6, 2020

© 2020 Lam et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: The study aimed to determine the efficacy and outcomes of EAVAST in the treatment of middle and proximal phalangeal fractures in comparison with surgical management.

Methods: A retrospective cohort study has reviewed the outcomes of middle and proximal finger phalangeal fractures managed by EAVAST (n= 54) compared to surgical cases (n=47) in a public hospital over a 3-year period. Age range was 13-77 years. Outcome measures utilized included total active motion (TAM), clinical outcome measures (Belsky criteria), and grip strength. Main method of treatment was used for analysis grouping.

Results and Conclusions: In finger fractures at eight weeks post fracture, a mean 230o TAM (95% CI range 90o-285o, SD 34.2) was achieved with traction (n=54) compared to mean 198o TAM (95% CI range 50o-286o, SD 54.8) for surgical cases (n=47). The results were statistically significant (p<0.001). In the traction group, results were excellent in 18%, good in 41% and poor in 33% cases by Belsky's criteria. In the surgical group excellent results were present in 9%, good in 28% and poor in 50%.

There were no significant differences in grip strength between the traction and surgical groups.

The groups were similar in age and handedness, the traction group received more comminuted fractures (61%) than the surgical group (43%). ANOVA regression analysis showed age to be statistically significant in effect on data variation (p=0.026). Intra-articular classification (p=0.08), comminution (p=0.91), and location of fracture (p=0.41) were not statistically significant.

The traction group had less complications (5%) than the surgical group (22%).

This study shows EAVAST may provide improved TAM and clinical outcomes compared to surgery with less complications and should be considered an effective option for the management of middle and proximal phalangeal fractures of the hand.