Where open reduction and internal fixation is used in metacarpal or phalangeal fractures of the hand, the margin of error in an anatomically difficult area is very small. If conservative treatment is used, however, joints and dynamic structures in the hand are immobilized, possibly to their detriment, and even so, reduction may not be successfully maintained.
External fixation with the Pennig Minifixator combines the advantage of secure fragment fixation with a minimally invasive procedure. Soft tissue dissection is not necessary, since in general, indirect reduction is employed.
Until now, external fixation in the hand has required bridging of the joint in more than 40% of cases (Asche andBurny) because of the design of the fixator clamp. The Pennig Minifixator allows for the placement of threaded wires parallel to the joint surface and thus requires only minimal space for its application. Inventory is reduced, since the threaded wires do not need predrilling and are trimmed to length.
With this system, the traditional three "R's" of fracture treatment: Reduction, Retention and Rehabilitation are accomplished with a highly favorable risk/benefit ratio for both patient and surgeon.
Indications for its use in the hand and foot include:
- Aseptic and Infected nonunions
- Corrective Osteotomy
- Soft Tissue Correction
- Secure fragment fixation with minimally invasive procedure
- Soft tissue dissection not necessary
- Allows placement of threaded wires parallel to joint surface and thus requires only minimal application space
- Reduced inventory since threaded wires do not need predrilling and are trimmed to length
Physician Support Materials
- Brochure - Pennig Minifixator
- Operative Technique*: Treatment of Fractures and Deformities in Small Bones – The Pennig Minifixator
- Quick Reference Guide*: Treatment of Fractures and Deformities in Small Bones – The Pennig Minifixator
*Proper surgical procedure is the responsibility of the medical professional. Operative techniques are furnished as an informative guideline. Each surgeon must evaluate the appropriateness of a technique based on his or her personal medical credentials and experience. Please refer the the "Instructions for Use" supplied with the product for specific information on indications for use, contraindications, warnings, precautions, adverse reaction information and sterilization.
- Asche G., Burny F. - Indikation für die Anwendung des Minifixateur externe, eine statistische Analyse. Aktuelle Traumatologie, (1982), 12: 103-110.
- Asche G. - Stabilisierungsmöglichkeit einer intraartikulären Trümmerfraktur des I. Mittelhandknochens mit dem Minifixateur externe. Handchirurgie, (1981), 13: 247-249.
- Barton N.J. Fractures of the hand. J. Bone Joint Surg., (1984), 66-B: 159-167.
- Dobyns J.H., Linscheid R.L., Cooney W.P. III - Fractures and dislocation of the wrist and hand, then and now. J. Hand Surg., (1983), 8: 687-690.
- Heim V., Pfeiffer K.M. - Small fragment set manual. 1st and 2nd eds. (1974, 1982), Berlin, Heidelberg, New York; Springer-Verlag.
- James J.I.P. - Fractures of the proximal and middle phalanges of the fingers. Acta Orthop. Scand., (1962), 32: 401-412.
- Pennig D., Gausepohl T., Lukosche R. - The multidirectional minifixator. In: Cziffer E (Ed.). Minifixation. External Fixation of small bones. Literatura Medica, Budapest 1994; 27-32.
- Pennig D., Gausepohl T., Lukosch R. - Externe Fixation zur Unterstützung der Weichteilrekonstruktion in der Handchirurgie. Handchir. Mikrochir. Plast. Chir. 1995; 27: 264-268.
- Pennig D., Gausepohl T., Mader K., Wulke A. - The use of minimally invasive fixation in fractures of the hand –The Minifixator concept. Injury, 2000; 31 Suppl. 1: 102-112.
- Pennig D., Gausepohl T. - Metacarpal Fractures, Phalangeal Fractures and Reconstructive Procedures: The Pennig Minifixator in the Hand. In: Orthofix External Fixation in Trauma and Orthopaedics. G. De Bastiani, A.G. Apley, A. Goldberg (Eds), Springer, 2000: 195-218.
- Segmuller G. - Surgical Stabilization of the Skeleton of the Hand (1977). Williams and Wilkins, Baltimore.
Patient Support Materials
- Quick Reference Guide: Treatment of Fractures and Deformities in Small Bones – The Pennig Minifixator
Contraindications to the use of the Pennig Minifixator in the hand and foot are similar to those for external fixation in general. These include severe osteoporosis, patients who are HIV positive and patients with severe, poorly controlled diabetes mellitus. In addition, in uncooperative or predictably difficult patients, external fixation is not advisable. Careful patient selection will therefore avoid problems at a later stage.