Mini-plate fixation for complicated metacarpal fractures:better than Kirschner wire fixation / 中国组织工程研究

ABSTRACT

BACKGROUND:Fracture must be properly reset, cannot present angle, rotation and overlapping shift. Kirschner wire fixation is fit for transverse fracture of first metacarpal bone of proximal phalanx and middle phalanx. Mini-plate fixation is fit for disfigurement or short bevel fracture of metacarpal bone and proximal finger backbone. Which is fit for cmplicated fracture of metacarpal bone? OBJECTIVE:To analyze the clinical effective and safety of complicated metacarpal fractures after fixed with mini-plates and Kirschner wires. METHODS:A total of 68 cases of complicated metacarpal fractures (72 sites) were chosen from Sanshui Hospital of Foshan Municipal Hospital of Traditional Chinese Medicine as the research subjects. They received open reduction and internal fixation, and were divided into two groups. Mini-plate group contained 36 cases (39 sites). Kirschner wire group contained 32 cases (33 sites). Healing time of metacarpal and phalangeal fractures, functional recovery and wound infection were observed. Clinical effects and complications were compared between the two groups. Bone healing was observed using X-ray. The recovery of hand function was evaluated using total action flexion score of American Society for Surgery of the Hand. RESULTS AND CONCLUSION:Patients in the mini-plate group were fol owed up for 3-12 months, and patients in the Kirschner wire group were fol owed up for 3-10 months. In the mini-plate group, the excel ent and good rate of total action flexion score was 92%. X-ray films revealed that healing time was 4-6 weeks, averagely 4.7 weeks. Complicationsno bone nonunion occurred. Moreover, patients with closed fracture did not suffer from postoperative infection. Patients with open fracture suffered from infection to different degrees at three fracture sites. In the Kirschner wire group, the excel ent and good rate of total action flexion score was 76%. X-ray films demonstrated that healing time was 6-9 weeks, averagely 7.7 weeks. Complicationsbone nonunion was observed at three fracture sites. After bone grafting, postoperative infection was found in 4 sites of 28 sites of open fracture. Statistical analysis showed that significant differences in total action flexion score were detectable between the two groups at 3 months of fol ow-up (P<0.05). These results suggest that the clinical effect of mini-plate fixation for complicated metacarpal fracture was apparently better than that of Kirschner wire, so mini-plate fixation can be used as an effective repair method for complicated metacarpal fracture.