ObjectiveTo discuss the clinical curative effect of internal fixation for metacarpal and phalanx fractures using stainless steel mini-plate and the early rehabilitation. MethodsThe study included 47 cases treated from January 2006 to June 2011, including 25 cases of 72 phalangeal fractures, 17 cases of 43 metacarpal fractures, and 5 cases of 23 complex metacarpal and phalangeal fractures. All the patients underwent open reduction and micro-plate internal fixation. Three days after surgery, passive function training was initiated. Patients accompanied with blood vessel damage began the training one week later. The training was carried out based on the early rehabilitation schedule. ResultsPrimary healing occurred in all the 47 cases. There was one case of broken plate because of crashing. Postoperative follow-up lasted for 4 to 10 months, and the fractures were healed in 138 lesions. X-ray examination showed that bone union took place at week 8 to 11 averaging at 10. According to the functional evaluation of total autive movement scales, the excellent and good rate was 83.0%. ConclusionThe stainless steel mini-plate in the treatment of metacarpal and phalangeal fractures has a firm fixation and is advantageous. Combined with early rehabilitation training, it can maximize the recovery of hand function with satisfactory clinical results.
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.