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OBJECTIVE@#To explore the clinical effect of manual reduction combined with homemade splint external fixation in the treatment of metacarpal fractures.@*METHODS@#A retrospective analysis was performed in 126 patients with metacarpal fracture treated by manual reduction and homemade splint external fixation in the emergency department of our hospital from January 2018 to December 2018, including 102 male, 24 female, ranging in age from 9 to 73 year old, with an average of (33.2±14.3)years old. During the treatment, the X-ray was re-examined regularly, and the external fixation was continued or adjusted according to the X-ray situation. The X-ray showed callus growth. After the fracture was stable, the external fixation was removed to continue functional exercise. The TAM scoring standardwas used to evaluate the hand function, and the fracture healing and complications were summarized.@*RESULTS@#Of the 126 patients, 6 patients were treated with operation because of fracture displacement during the treatment. The other 120 patients were treated with this method and all of them got bony healing. The healing time was (6.3±1.8) weeks. The follow up time ranged from 2 to 12 months, with a mean of (4.4±2.2) months. At the latest follow up, TAM score was used to evaluate the hand function:excellent in 105 cases, good in 13 cases, fair in 2 cases and poor in 0 case. Shortening deformity was found in 7 cases and angulation deformity in 3 cases.@*CONCLUSION@#Manual reduction combined with homemade splint external fixation in the treatment of metacarpal fractures can achieve good clinical results. Homemade splint is easy to obtain materials and low cost, and it is an effective method worthy of clinical promotion.
Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Fixadores Externos , Fixação de Fratura , Fixação Interna de Fraturas , Ossos Metacarpais , Estudos Retrospectivos , Contenções , Resultado do TratamentoRESUMO
Background and Objectives: Early techniques of splint immobilization work well for simple metacarpal fractures. However, if significantly shorting, rotational deformity, and angulations occur, surgical treatment is required. The aim of this article was to study the functional outcome of metacarpal fractures treated by open reduction and internal fixation with mini plates and screw in low resource condition of Nepal.Material and Methods: This retrospective study was done over a period of one year 2012 to 2013 in Bir Hospital, Patan hospital and Shree Birendra hospital. The functional outcome after treatment was assessed by ability to perform acts of daily life and calculating American Society for Surgery of the Hand Total Active Flexion (ASSH-TAF).Results: Out of 30 patients twenty three were male (76.7%) and seven were female (23.3%). Among them, 7 patients (23.3%) showed union in 6 weeks. 18 Patients (60%) had union in 4 weeks. 3 patients (10%) had at five weeks and 2 patients had union at 6 weeks. We observed ASSH-TAF score at 2 weeks, 1month, 3 months, and 6 months. Results showed 24 patients (80%) had excellent, 4(13.3%) had good and 2(6.7%) had poor result.Conclusion: The use of miniplate and screws is a reasonable option for treating in displaced metacarpal fracture as it provides a rigid, Secure an anatomical stable reduction, which is sufficient to allow early mobilization of the adjacent joints, hence the mini plate fixation is effective means of immobilization of fracture of metacarpal with less complication and excellent functional outcome.
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Objective To discuss the clinical efficacy of internal fixation with miniature steel plate and kirschner pins in treatment for metacarpal neck fracture.Methods A total of 142 patients with cervix metacarpal fracture in our hospital from January 2015 to December 2016 were divided into the control group(n =71) and the observation group(n =71) randomly.The patients in control group were treated with internal fixation with kirschner pins,and the patients in observation group were treated by internal fixation with miniature steel plate.The operative time,postoperative healing time,postoperative pain,metacarpophalangeal joint function and complications were compared between the two groups.Results The operation time of observation group was (38.4 ± 3.8) minutes,the fracture healing time was (3.1 ± 1.4)weeks,the excellent and good rate of TAM was 97.2％ after operation,the excellent and good rate of FAFS was 98.6％ after operation,all these indexes were significantly better than those in the control group with statistical significance (P ＜ 0.05).Conclusion Internal fixation with miniature steel plate in the treatment of cervix metacarpal fracture has the advantages of exact clinical effect,short operative time,quick fracture healing and good recovery of joint function.
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The first metacarpal fracture is very common in forensic identification process,it often affects the function of the thumb,and how to correctly assess the degree of loss of thumb function become a focus in the fields of forensic medicine.We review the existing problems in the forensic identification of the first metacarpal fracture.
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We report one case of snapping metacarpo-phalangeal joint after depressed fracture of metacarpal neck which could be diagnosed by exploration for the snapping during extension in spite of conservative treatments.
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Articulações , PescoçoRESUMO
To study the characteristic of the metacarpal fracture and the forensic investigation of severity of the injury.52 cases with metacarpal fracture were reviewed.The incidence and the location as well as the patterns of fracture were analyzed.The severity of the fracture were different with different mechanism.