Treatment of metacarpal and phalangeal articular fracture dislocation: external fixation device or mini plate
10.3760/cma.j.issn.0253-2352.2010.07.007
- VernacularTitle:微型万向外固定器与微型钢板治疗掌指骨关节内骨折脱位的疗效比较
- Author:
Fengming TANG
;
Dong ZHAO
;
Peng XIE
;
Jinggui WANG
;
Jia NING
- Publication Type:Journal Article
- Keywords:
Metacarpal bone;
Finger phalanges;
Fractures;
External fixators;
Internal fixators
- From:
Chinese Journal of Orthopaedics
2010;30(7):662-665
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical outcome of external fixation device with Kirschner wire or fragment fixation pin with mini plate and screw fixation in treatment of metacarpal and phalangeal articular fracture dislocation. Methods From October 2002 to March 2008, 106 patients with metacarpal and phalangeal articular fracture dislocation were randomly divided into A and B group. The 53 patients in A group were treated with external fixation device with Kirschner wire or fragment fixation pin. There were thumb injury in 24 cases, fracture-dislocation of proximal interphalangeal joint(PIP) in 36 cases, fracture-dislocation of metacarpophalangeal joint (MP) in 17 cases. The 53 patients in B group were treated with mini plate and screw fixation. There were thumb injury in 22 cases, fracture-dislocation of PIP in 30 cases, fracture-dislocation of MP in 23 cases. Duncan rating criteria were used to compare finger range of motion. Results The mean follow-up of 16.8 and 17.5 months in A group and B group. According to Duncan rating criteria, there were excellent in 33 cases, good in 16, fair in 3, and poor in 1 case. The excellent and good rate was 92.5% in A group. There were excellent in 30 cases, good in 17, fair in 5, and poor in 1 case. The excellent and good rate was 88.7% in B group. In A group, 1 case of wound infection was found. The average arc of motion of thumb joint was 134°±21° while the average arc of motion of other fingers was 248°±19°. In B group, no wound infection occurred. The average arc of motion of thumb joint was 122°±18° while the average arc of motion of other fingers was 225°±17°. Conclusion External fixation device with Kirschner wire or fragment fixation pin was better than the application of mini plate and screw fixation in treatment of metacarpal and phalangeal articular fracture-dislocation.
