Abstract
Objective To explore the effect of joint use of external minifixator and titanium lockplate on total active motion (TAM) range and hand function recovery in comminuted metacarpal and phalanx fracture patients. Methods The medical data of 70 patients with comminuted metacarpal and phalanx fracture treated in our hospital from June 2017 to June 2020 were screened for the retrospective study, and the patients were divided into the control group (Kirschner wire internal fixation) and the study group (an external minifixator with titanium lockplate) according to the treatment modalities, with 35 cases each. After treatment, the clinical efficacy of patients was compared between the two groups. Results No between-group differences in patients' general data were observed (P > 0.05); the time for hospital stay and fracture healing was obviously shorter in the study group than that in the control group (P < 0.05); after treatment, the study group obtained significantly higher TAM range good rate (P < 0.05), significantly higher Carroll hand function test pass rate (P < 0.05), and obviously better grip strength of both hands and score on digital opposition of thumb than those in the control group (P < 0.05); and after surgery, the study group had significantly lower incidence rates of complications such as infection, local inflammation, displacement of bone, and adhesion of tendon that those in the control group (P < 0.05). Conclusion Joint use of an external minifixator and titanium lockplate can effectively promote the TAM range and accelerate hand function recovery for comminuted metacarpal and phalanx fracture patients and is conducive to reducing the incidence of postoperative complications, which is safe and has significant efficacy.
Highlights
For patients with closed fracture, brachial plexus block was performed; an arc incision was made at the dorsal metacarpophalangeal joint or interphalangeal joint, and an s-shaped incision was made at the distal interphalangeal joint; the extensor tendon was cut open longitudinally, and the articular capsule was cut open horizontally to fully expose the fracture end; according to the fracture status of patients during surgery, the sequence of reduction, internal fixation with a titanium lockplate, and installation of an external minifixator was determined; for patients in the control group, only internal fixation with the Kirschner wire was performed [8,9,10,11]
Metacarpophalangeal joints are highly specific to other parts, and metacarpal and phalanx are composed of short tubular bones with multiple joints and complex surrounding structure of the bone and are highly functionally demanding and topographically influencing, requiring timely implementation of functional exercises to promote early rehabilitation [18, 19]
Comminuted metacarpal and phalanx fractures are more difficult to treat than fractures of long tubular bones of the extremities. e basic configuration of an external minifixator is unilateral, easy to operate, and less traumatic to the body, which has the following advantages: it does not affect the fracture end but enables transarticular fixation; it has little effect on soft or tendon tissues; it can adjust reduction by traction, distract to restore the joint space, and reduce the incidence of traumatic arthritis; it may promote fracture healing by adjusting compression; and it can assist the fixation of open fractures
Summary
To explore the effect of joint use of external minifixator and titanium lockplate on total active motion (TAM) range and hand function recovery in comminuted metacarpal and phalanx fracture patients. Joint use of an external minifixator and titanium lockplate can effectively promote the TAM range and accelerate hand function recovery for comminuted metacarpal and phalanx fracture patients and is conducive to reducing the incidence of postoperative complications, which is safe and has significant efficacy. A total of 70 patients with comminuted metacarpal and phalanx fracture treated in our hospital from June 2017 to June 2020 were screened for the retrospective study, among which 35 cases were treated by using an external minifixator with titanium lockplate and showed higher satisfaction with clinical efficacy at postoperative follow-up.
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