Application of accelerated rehabilitation surgery concept in the treatment of metacarpal fractures with absorbable rods

Abstract

Objective To explore the clinical efficacy of absorbable rod in the treatment of metacarpal fractures under the guidance of accelerated rehabilitation surgery concept. Methods From August 2016 to August 2018, 53 patients with long oblique and spiral metacarpal fractures were treated with absorbable rod by fixation perpendicular to the fracture line. The patients were divided into observation group and control group according to whether they were treated with the concept of accelerated rehabilitation surgery during perioperative period or not. There were 24 cases in the observation group (28 places) and 29 cases in the control group (31 places). The visual analogue scale (VAS) on the first day after operation, the time when the active range of motion of metacarpophalangeal joint returned to normal, the time of fracture healing and the functional evaluation results of the injured hand at the last follow-up were compared between the two groups. Results All the patients were follow-up for 1 to 12 months with an average of 9.2 months. All the incisions achieved primary healing and all the fractures were healed. On the first day after operation, VAS and the recovery time of metacarpophalangeal joint activity in the observation group were (2.64±0.81) points and (19.35±2.12) days, respectively, which were significantly lower than those in the control group (3.42±1.13) points and (28.63±1.31) days. The differences were statistically significant (t=-2.920, -14.665, P 0.05). There was no significant difference in hand function evaluation between the two groups at the last follow-up (χ2=0.045, P>0.05). Conclusion The technique of absorbable rod by fixation perpendicular to the fracture line for long oblique or spiral metacarpal fractures is a safe and effective surgical method. With the guidance of accelerated rehabilitation surgery concept, hand function can be better restored and satisfactory clinical efficacy can be obtained. Key words: Metacarpal bones; Fractures,bone; Absorbable rod; Accelerated rehabilitation surgery