Kirschner wire and mini-plate fixation in repair of metacarpal and phalangeal fractures: hand function and adverse reactions / 中国组织工程研究

ABSTRACT

BACKGROUND:Kirschner wire fixation is the most extensive method to repair metacarpal and phalangeal fractures,but it has some disadvantages such as poor stability and many complications.Present studies suggest that surface rigidity,stability of fracture fragments and fracture healing of mini-plate were better than other fixation methods.Based on anatomical reduction,mini-plate fixation can firmly fix the bone,does not destroy articular surface,so it can restore hand function to the maximum extent.OBJECTIVE:To compare and analyze the therapeutic effects and adverse reactions of Kirschner wire and mini-plate fixation for repair of metacarpal and phalangeal fractures.METHODS:A total of 76 patients with metacarpal and phalangeal fractures,who accepted surgical treatment in Department of Orthopedics,Yixing No.2 People's Hospital from January 2011 to January 2014,were selected.Patients were randomly divided into observation group and control group,with 38 cases in each group.The patients in the observation group (46 places) were treated by mini-plate fixation,while those in the control group (50 places) were fixed with Kirschner wire.Hand function was evaluated after treatment.Healing and complications were compared in both groups.RESULTS AND CONCLUSION:The excelent and good rate in the observation group was 91％(42/46),and 68％(34/50) in the control group,and the significant differences between the two groups were detected (P＜0.05).Total active flexion degree,length of hospital stay and healing time were respectively (147.2±89.6)°,(5.1±2.1) days and (51.4±18.3) days in the observation group,and (132.4±35.3)°,(6.9±2.4) days and (65.5±23.8) days in the control group.Length of hospital stay and healing time were shorter,but total active flexion was greater in theobservation group than in the control group (P＜0.05).Incidence of infection and delayed healing of bone were significantly lower in the observation group than in the control group (P＜0.05).Results suggest that compared with the Kirschner wire,mini-plate fixation for metacarpal and phalangeal fractures can obviously improve hand function,shorten length of hospital stay and healing time.It is safe and reliable,and is one of good clinical treatment options.