Comparison of the clinical curative effect between dynamic external fixator and hand orthosis in patients with middle phalanx pars basilaris fracture / 中国医师进修杂志

ABSTRACT

Objective To discuss the clinical curative effect between dynamic external fixator (DEF) and hand orthosis (HO) in patients with middle phalanx pars basilaris fracture. Methods A total of 143 patients with middle phalanx pars basilaris fracture were selected from January 2015 to April 2016. The patients were divided into 2 groups according to the patients′select DEF group (83 cases) and HO group (60 cases). The patients in DEF group were treated with DEF fixation under local nerve block anesthesia of digital root, and the patients in HO group were treated with HO fixation after manual repositioning. The fracture healing time and complications were observed. All patients were functionally trained and evaluated by total active motion (TAM). Results The patients were followed up for 8 to 16 weeks, with an average of 12 weeks. There was no statistical difference in fracture healing time between 2 groups (P＞0.05). All patients had postoperative pain, but the incidence of postoperative pain after removing DEF or HO in DEF group was significantly lower than that in HO group 26.51% (22/83) vs. 46.67% (28/60), and there was statistical difference (P＜0.05). No redislocation or subluxation occurred after removal of external fixation in 2 groups. X-ray follow-up showed that the incidences of mild traumatic osteoarthritis, mild angulation deformity and mild lateral instability in DEF group were significantly lower than those in HO group 6.02% (5/83) vs. 23.33% (14/60), 3.61% (3/83) vs. 33.33% (20/60) and 1.20% (1/83) vs. 26.67% (16/60), and there were statistical differences (P＜0.05). The excellent and good rate of TAM in DEF group was significantly higher than that in HO group 83.13% (69/83) vs. 63.33% (38/60), and there was statistical difference (χ2=7.25, P＜0.01). Conclusions The clinical curative effect of DEF fixation is better than HO fixation in patients with middle phalanx pars basilaris fracture.