Effectiveness comparison between ultrasound-guided and C-arm-guided in closed reduction and pinning for treatment of metacarpophalangeal fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Lei ¹ ,  WANG Xiaohui ² , LI Wuyin ²

1. Hunan University of Chinese Medicine, Changsha Hunan, 410000, P.R.China;
2. Department of Hand Micro Orthopedics, Luoyang Orthopedic Hospital of Henan Province (Orthopedic Hospital of Henan Province), Luoyang Henan, 471002, P.R.China;

Corresponding author：

WANG Xiaohui, Email: 963099784@qq.com

Keywords：

Ultrasonography; metacarpophalangeal fracture; internal fixation

DOI：

10.7507/1002-1892.201705037

Video：

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Objective To compare the effectiveness between ultrasound-guided and C-arm-guided in closed reduction and pinning for the treatment of metacarpophalangeal fractures. Methods The clinical data of 30 patients with metacarpophalangeal fractures between October 2015 and November 2016 were retrospectively analyzed. According to different treatments, the patients were divided into ultrasound group (using ultrasound-guided closed reduction and pinning, n=15) and C-arm group (using C-arm-guided closed reduction and pinning, n=15). There was no significant difference in gender, age, disease duration, causes of injury, injured finger, location of injury finger, fracture classification between 2 groups (P>0.05). The status and success rate of reduction were compared (excellent, good, and acceptable grades could be regarded as the successful reduction). The operation time, intraoperative fluoroscopy times, and fracture healing time were recorded. And the postoperative functional recovery was evaluated according to the total active movement (TAM) by the standard functional evaluation issued by Hand Surgery Association of Chinese Medical Association. Results The operation time of ultrasound group was longer than C-arm group, and the intraoperative fluoroscopy times was less than C-arm group, all showing significant differences (P<0.05). There was no signifi cant difference in the grade and the success rate of reduction between 2 groups (P>0.05). All the patients were followed up 6-18 months (mean, 10 months), without malunion, joint stiffness, tendon adhesions, and other complications. There was also no significant difference in the fracture healing time, the grade of TAM, and the excellent and good rate of TAM between 2 groups (P>0.05). Conclusion The treatment of ultrasound-guided closed reduction and pinning for metacarpophalangeal fractures is effective, which is a feasible auxiliary method of closed reduction and fixation for fracture. And less fluoroscopy can reduce the radiation damage of operation.

Citation： WANG Lei, WANG Xiaohui, LI Wuyin. Effectiveness comparison between ultrasound-guided and C-arm-guided in closed reduction and pinning for treatment of metacarpophalangeal fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(10): 1179-1183. doi: 10.7507/1002-1892.201705037 Copy

1.	夏晓明. 克氏针与微型钢板置入内固定修复掌指骨骨折: 手部功能及不良反应随访. 中国组织工程研究, 2015, 19(17): 2741-2744.0.
2.	王亦璁, 姜保国. 骨与关节损伤. 5 版. 北京: 人民卫生出版社, 2014: 918.
3.	黄俊伍, 陈云丰, 罗轶, 等. 闭合复位顺行双弹性钉固定治疗掌骨骨折疗效分析. 中华手外科杂志, 2013, 29(5): 263-266.0.
4.	潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3): 130-135.0.
5.	于德江, 江朝光, 李众利, 等. 超声在汶川地震骨折诊断中的应用. 中华医学超声杂志(电子版), 2008, 5(5): 782-788.0.
6.	Neri E, Barbi E, Rabach I, et al. Diagnostic accuracy of ultrasonography for hand bony fractures in paediatric patients. Arch Dis Child, 2014, 99(12): 1087-1090.
7.	Mahaisavariya B, Songcharoen P, Riansuwan K. Technique of closed unlocked femoral nailing using ultrasound guidance. Injury, 2006, 37(10): 1000-1003.
8.	孙金占, 刘赟, 李勇, 等. 超声在四肢骨折闭合复位髓内钉内固定术中的临床应用. 中国骨与关节损伤杂志, 2012, 27(9): 858-859.0.
9.	Dubrovsky AS, Kempinska A, Bank I, et al. Accuracy of ultrasonography for determining successful realignment of pediatric forearm fractures. Ann Emerg Med, 2015, 65(3): 260-265.
10.	Rabiner JE, Khine H, Avner JR, et al. Accuracy of point-of-Care ultrasonography for diagnosis of elbow fractures in Children. Ann Emerg Med, 2013, 61(1): 9-17.
11.	Weinberg ER, Tunik MG, Tsung JW. Accuracy of clinician-performed point-of-care ultrasound for the diagnosis of fractures in children and young adults. Injury, 2010, 41(8): 862-868.
12.	Herren C, Sobottke R, Ringe MJ, et al. Ultrasound-guided diagnosis of fractures of the distal forearm in children. Orthop Traumatol Surg Res, 2015, 101(4): 501-505.
13.	Kodama N, Takemura Y, Ueba H, et al. Ultrasound-assisted closed reduction of distal radius fractures. J Hand Surg (Am), 2014, 39(7): 1287-1294.
14.	兰俊, 周明平, 周崇斌, 等. 超声对股骨干骨折移位和复位及闭合复位髓内钉固定术的指导意义. 中华超声影像学杂志, 2016, 25(7): 616-619.0.
15.	Wellsh BM, Kuzma JM. Ultrasound-guided pediatric forearm fracture reductions in aresourcelimited ED. Am J Emerg Med, 2016, 34(1): 40-44.
16.	赵丽, 赵胜军, 金宝城, 等. 高频超声在儿童不稳定尺桡骨骨折靶向引导弹性髓内钉内固定中的应用. 大连医科大学学报, 2016, 38(4): 352-355.0.
17.	陆建华, 施晓健, 黄莉, 等. 高频超声引导 Colles 骨折手法复位的价值. 南通大学学报(医学版), 2010, 30(3): 164-166.0.
18.	王孝辉, 沈素红, 李德, 等. 超声引导下闭合复位穿针固定治疗成人指骨骨折. 中华超声影像学杂志, 2016, 25(9): 804-807.0.

1. 夏晓明. 克氏针与微型钢板置入内固定修复掌指骨骨折: 手部功能及不良反应随访. 中国组织工程研究, 2015, 19(17): 2741-2744.0.
2. 王亦璁, 姜保国. 骨与关节损伤. 5 版. 北京: 人民卫生出版社, 2014: 918.
3. 黄俊伍, 陈云丰, 罗轶, 等. 闭合复位顺行双弹性钉固定治疗掌骨骨折疗效分析. 中华手外科杂志, 2013, 29(5): 263-266.0.
4. 潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3): 130-135.0.
5. 于德江, 江朝光, 李众利, 等. 超声在汶川地震骨折诊断中的应用. 中华医学超声杂志(电子版), 2008, 5(5): 782-788.0.
6. Neri E, Barbi E, Rabach I, et al. Diagnostic accuracy of ultrasonography for hand bony fractures in paediatric patients. Arch Dis Child, 2014, 99(12): 1087-1090.
7. Mahaisavariya B, Songcharoen P, Riansuwan K. Technique of closed unlocked femoral nailing using ultrasound guidance. Injury, 2006, 37(10): 1000-1003.
8. 孙金占, 刘赟, 李勇, 等. 超声在四肢骨折闭合复位髓内钉内固定术中的临床应用. 中国骨与关节损伤杂志, 2012, 27(9): 858-859.0.
9. Dubrovsky AS, Kempinska A, Bank I, et al. Accuracy of ultrasonography for determining successful realignment of pediatric forearm fractures. Ann Emerg Med, 2015, 65(3): 260-265.
10. Rabiner JE, Khine H, Avner JR, et al. Accuracy of point-of-Care ultrasonography for diagnosis of elbow fractures in Children. Ann Emerg Med, 2013, 61(1): 9-17.
11. Weinberg ER, Tunik MG, Tsung JW. Accuracy of clinician-performed point-of-care ultrasound for the diagnosis of fractures in children and young adults. Injury, 2010, 41(8): 862-868.
12. Herren C, Sobottke R, Ringe MJ, et al. Ultrasound-guided diagnosis of fractures of the distal forearm in children. Orthop Traumatol Surg Res, 2015, 101(4): 501-505.
13. Kodama N, Takemura Y, Ueba H, et al. Ultrasound-assisted closed reduction of distal radius fractures. J Hand Surg (Am), 2014, 39(7): 1287-1294.
14. 兰俊, 周明平, 周崇斌, 等. 超声对股骨干骨折移位和复位及闭合复位髓内钉固定术的指导意义. 中华超声影像学杂志, 2016, 25(7): 616-619.0.
15. Wellsh BM, Kuzma JM. Ultrasound-guided pediatric forearm fracture reductions in aresourcelimited ED. Am J Emerg Med, 2016, 34(1): 40-44.
16. 赵丽, 赵胜军, 金宝城, 等. 高频超声在儿童不稳定尺桡骨骨折靶向引导弹性髓内钉内固定中的应用. 大连医科大学学报, 2016, 38(4): 352-355.0.
17. 陆建华, 施晓健, 黄莉, 等. 高频超声引导 Colles 骨折手法复位的价值. 南通大学学报(医学版), 2010, 30(3): 164-166.0.
18. 王孝辉, 沈素红, 李德, 等. 超声引导下闭合复位穿针固定治疗成人指骨骨折. 中华超声影像学杂志, 2016, 25(9): 804-807.0.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness comparison between ultrasound-guided and C-arm-guided in closed reduction and pinning for treatment of metacarpophalangeal fractures

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