Management of mangled hand injuries with JESS fixator in a tertiary care hospital in North East India: A prospective study

Introduction: Mangled hand injuries have proved to be a tough challenge for both the patients and surgeons alike. Severe bony and soft tissue injuries necessitate the requirement of a multidisciplinary approach.Materials: In our tertiary care facility, a prospective study was done on the use of the Joshi's external stabilization system (JESS) fixator in the treatment of 31 instances with mangled hand injuries from November 2019 to November 2020. The cases were evaluated for functional outcome at the end of 12 months of follow up.Results: 31 cases of mangled hand injuries with 43 fractures were treated with the said intervention. The mean age of the patients was 33.7 +/- 4.2 years and almost 90% patients were males. Machinery injuries were the most frequent type of injury (55%). Cases were intervened at an emergency basis within 24 h of the injury. Functional evaluation was done by Modified Mayo Wrist Score with an average score of 84 +/- 10. Good results were seen in about 60% of cases and there were no Poor results.Conclusion: The application of JESS fixator for the prompt treatment of mangling hand injuries yielded satis-factory results in the working population with an early return to function. The strict adherence to the principles of ligamentotaxis, appropriate wound care and post-operative physiotherapy are other variables in the final outcome of such injuries.Level of evidence: II.