Efficacy of micro steel plate and Kirschner needle oblique and transverse internal fixation of adjacent metacarpal bone in the treatment of metacarpal diaphyseal oblique fracture / 中国骨伤

OBJECTIVE@#To compare the clinical efficacy of micro steel plate and Kirschner needle oblique and transverse internal fixation of adjacent metacarpal bone in the treatment of metacarpal diaphyseal oblique fracture.@*METHODS@#Fifty-nine patients with metacarpal diaphyseal oblique fractures admitted between January 2018 and September 2021 were selected as the study subjects and divided into the observation group (29 cases) and the control group (30 cases) based on different internal fixation methods. The observation group was treated with Kirschner wire oblique and transverse internal fixation of adjacent metacarpal bones, while the control group was treated with micro steel plate internal fixation. Postoperative complications, operation time, incision length, fracture healing time, treatment cost, and metacarpophalangeal function were compared between the two groups.@*RESULTS@#No incision or Kirschner wire infections occurred in the 59 patients, except for one in the observation group. No fixation loosening, rupture, or loss of fracture reduction occurred in any of the patients. The operation time and incision length in the observation group were (20.5±4.2) min and (1.6±0.2) cm, respectively, which were significantly shorter than those in the control group (30.8±5.6) min and (4.3±0.8) cm (P<0.05). The treatment cost and fracture healing time in the observation group were (3 804.5±300.8) yuan and (7.2±1.1) weeks, respectively, which were significantly lower than those in the control group (9 906.9±860.6) yuan and (9.3±1.7) weeks (P<0.05). The excellent and good rate of metacarpophalangeal joint function in the observation group was significantly higher than that in the control group at 1, 2, and 3 months after operation (P<0.05), but there was no significant difference between the two groups at 6 months after operation (P>0.05).@*CONCLUSION@#Micro steel plate internal fixation and Kirschner wire oblique and transverse internal fixation of adjacent metacarpal bones are both viable surgical methods for treating metacarpal diaphyseal oblique fractures. However, the latter has the advantages of causing less surgical trauma, shorter operation time, better fracture healing, lower cost of fixation materials, and no need for secondary incision and removal of internal fixation.

Biomechanical Study on Kirschner and Bandage Fixation for Treatment of Hallux Valgus after Minimally Invasive Surgery / 医用生物力学

Objective To investigate the effect of Kirschner and bandage fixation on the hallux valgus (HV) after distal osteotomy of the first metatarsus. Methods A comprehensive three-dimensional finite-element model of the foot was established based on medical images of the foot of a patient with HV, including bones, sesamoid, cartilage, ligaments, soft tissues, and Achilles tendon. The models of Kirschner and bandage fixation were also established to investigate the biomechanical behavior of the foot with HV during full weight-bearing standing. Results The compressive stress (14.9 MPa) between the osteotomy fragment surfaces in bandage fixation was higher than the peak stress of the Kirschner needle (6.71 MPa). The Kirschner fixation was better than the bandage fixation from the dorsal, plantar, medial, and lateral foot. Therefore, it was more favorable for the stability of the osteotomy. Conclusions The bandage fixation can reduce the healing time of osteotomy, providing an optimal design for fixation methods after hallux valgus operations.