Easy Flow with a MiniFlo? An External Distraction Device to Overcome Joint Flexion Contractions

Fuest L*, Haug L and Vögelin E

Department of Hand and Peripheral Nerve Surgery, University Hospital Bern, Switzerland

^*Correspondance to: Lena Fuest 

 PDF  Full Text DOI: 10.25107/2474-1647.3598

Abstract

Background: Flexion contractions of the PIP or the MCP joint are common in Dupuytren’s disease or after trauma. Several techniques and devices have been developed to treat this functionally impairing condition. One option for treatment is the “MiniFlo” device, an external distraction fixator positioned dorsally over the involved contracted joint with four bone screws. Methods: Between October 2019 and August 2020, nine patients with flexion contractures of the PIP or MCP joint were treated with eleven MiniFlo fixators. The patients are instructed to extend the involved finger joints by increasing the angle of the distraction device daily. After achieving the best possible extension, the MiniFlo fixator is dismantled, a splint applied or further surgeries planned. Results: After application of the MiniFlo device, an average of 29 days was required to correct a median flexion-contracture of 50°. Immediately after removal of the MiniFlo fixator, all patients showed an improvement of the passive and active extension of the involved joint. During regular follow-up examinations the maximum achieved improvement of the extension with the MiniFlo fixator could not be permanently maintained. In five of the cases, the flexion-contracture stabilized at 50% to 75% improvement compared to the maximum improvement gained at dismantling; in two cases each ~25% and ~12% improvement was achieved and could be maintained up to one year, respectively. In two joints, no permanent improvement could be demonstrated. Conclusion: The use of the fixator in severe Dupuytren’s disease or posttraumatic flexion contractures is a good option for slow stretching of the soft tissue. It allows a less aggressive option in preparation for further surgery in severe flexion contractures of 90°. However, based on the results of this study, the MiniFlo fixator cannot be considered as a stand-alone instrument to treat flexion contractures.

Keywords

Cite the article

Fuest L, Haug L, Vögelin E. Easy Flow with a MiniFlo? An External Distraction Device to Overcome Joint Flexion Contractions. Clin Surg. 2022; 7: 3598..