Ved Prakash Rao Cheruvu, Sunil Gaba, Jerry R John, Sourabh Rawat
{"title":"非拇指掌骨关节外干骨折的治疗:钢板螺钉固定与k针固定。","authors":"Ved Prakash Rao Cheruvu, Sunil Gaba, Jerry R John, Sourabh Rawat","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>Metacarpal fractures are common injuries and comprise nearly 36% to 42% of all fractures in the hand. The majority of these can be managed non-surgically. Operative fixation when needed, can be done by a variety of techniques. In this study, we have compared the outcomes of two techniques, plate-screw fixation and K-wire fixation. We have conducted a prospective, non-randomized, comparative study of patients who presented with extra-articular metacarpal shaft fractures of non-thumb metacarpals over a period of 18 months. 30 patients were enrolled according to the inclusion criteria and were alternately allotted to the plate-screw group and the K-wire group. At admission, patient demographics, clinical features, number of fractures, and fracture patterns were recorded, and radiographs were taken. In the plate-screw group, low-profile plates and screws were used, and in the K-wire group, 1 or 2 K-wires were used for fixation after fracture reduction. Hand mobilization exercises were started within one week in the plate-screw group, while in the K-wire group full mobilization was allowed at 4 weeks post-surgery. The Disabilities of Arm, Shoulder and Hand (DASH) score was calculated and compared between the two groups at 6 months and 12 months after surgery. The mean 6-month DASH score in the plate-screw group was 6.3287±2.2453, while it was 17.1627±6.2103 in the K-wire group (<i>p</i> value <0.001). At the end of 1-year follow-up, the mean DASH score in the plate-screw group was 5.1080±1.6637, and in the K-wire group, it was 5.1073±1.9392 (<i>p</i> value =0.848). In conclusion, extra-articular metacarpal shaft fractures of the non-thumb metacarpals treated by plate-screw fixation had significantly better DASH scores and hence better functional outcomes at the end of 6 months. However, at the end of 1 year, the DASH scores in both the groups were almost similar, suggesting similar functional outcomes in the long term.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"11 5","pages":"365-376"},"PeriodicalIF":1.4000,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8610815/pdf/ijbt0011-0365.pdf","citationCount":"0","resultStr":"{\"title\":\"Management of extra-articular shaft fractures of the non-thumb metacarpals: plate-screw fixation versus K-wire fixation.\",\"authors\":\"Ved Prakash Rao Cheruvu, Sunil Gaba, Jerry R John, Sourabh Rawat\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Metacarpal fractures are common injuries and comprise nearly 36% to 42% of all fractures in the hand. The majority of these can be managed non-surgically. Operative fixation when needed, can be done by a variety of techniques. In this study, we have compared the outcomes of two techniques, plate-screw fixation and K-wire fixation. We have conducted a prospective, non-randomized, comparative study of patients who presented with extra-articular metacarpal shaft fractures of non-thumb metacarpals over a period of 18 months. 30 patients were enrolled according to the inclusion criteria and were alternately allotted to the plate-screw group and the K-wire group. At admission, patient demographics, clinical features, number of fractures, and fracture patterns were recorded, and radiographs were taken. In the plate-screw group, low-profile plates and screws were used, and in the K-wire group, 1 or 2 K-wires were used for fixation after fracture reduction. Hand mobilization exercises were started within one week in the plate-screw group, while in the K-wire group full mobilization was allowed at 4 weeks post-surgery. The Disabilities of Arm, Shoulder and Hand (DASH) score was calculated and compared between the two groups at 6 months and 12 months after surgery. The mean 6-month DASH score in the plate-screw group was 6.3287±2.2453, while it was 17.1627±6.2103 in the K-wire group (<i>p</i> value <0.001). At the end of 1-year follow-up, the mean DASH score in the plate-screw group was 5.1080±1.6637, and in the K-wire group, it was 5.1073±1.9392 (<i>p</i> value =0.848). In conclusion, extra-articular metacarpal shaft fractures of the non-thumb metacarpals treated by plate-screw fixation had significantly better DASH scores and hence better functional outcomes at the end of 6 months. However, at the end of 1 year, the DASH scores in both the groups were almost similar, suggesting similar functional outcomes in the long term.</p>\",\"PeriodicalId\":45488,\"journal\":{\"name\":\"International Journal of Burns and Trauma\",\"volume\":\"11 5\",\"pages\":\"365-376\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2021-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8610815/pdf/ijbt0011-0365.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Burns and Trauma\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Burns and Trauma","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
Management of extra-articular shaft fractures of the non-thumb metacarpals: plate-screw fixation versus K-wire fixation.
Metacarpal fractures are common injuries and comprise nearly 36% to 42% of all fractures in the hand. The majority of these can be managed non-surgically. Operative fixation when needed, can be done by a variety of techniques. In this study, we have compared the outcomes of two techniques, plate-screw fixation and K-wire fixation. We have conducted a prospective, non-randomized, comparative study of patients who presented with extra-articular metacarpal shaft fractures of non-thumb metacarpals over a period of 18 months. 30 patients were enrolled according to the inclusion criteria and were alternately allotted to the plate-screw group and the K-wire group. At admission, patient demographics, clinical features, number of fractures, and fracture patterns were recorded, and radiographs were taken. In the plate-screw group, low-profile plates and screws were used, and in the K-wire group, 1 or 2 K-wires were used for fixation after fracture reduction. Hand mobilization exercises were started within one week in the plate-screw group, while in the K-wire group full mobilization was allowed at 4 weeks post-surgery. The Disabilities of Arm, Shoulder and Hand (DASH) score was calculated and compared between the two groups at 6 months and 12 months after surgery. The mean 6-month DASH score in the plate-screw group was 6.3287±2.2453, while it was 17.1627±6.2103 in the K-wire group (p value <0.001). At the end of 1-year follow-up, the mean DASH score in the plate-screw group was 5.1080±1.6637, and in the K-wire group, it was 5.1073±1.9392 (p value =0.848). In conclusion, extra-articular metacarpal shaft fractures of the non-thumb metacarpals treated by plate-screw fixation had significantly better DASH scores and hence better functional outcomes at the end of 6 months. However, at the end of 1 year, the DASH scores in both the groups were almost similar, suggesting similar functional outcomes in the long term.