Mini Plates Research Articles

Treatment of AO/OTA type 31-A3 intertrochanteric fracture with proximal femoral nail antirotation combined with mini plate reconstruction of lateral femoral wall

To explore the effectiveness of proximal femoral nail antirotation (PFNA) combined with mini plate for reconstruction of lateral femoral wall in the treatment of type AO/Orthopaedic Trauma Association (AO/OTA) type 31-A3 intertrochanteric fracture. The clinical data of 70 elderly patients with AO/OTA type 31-A3 intertrochanteric fracture treated between January 2013 and January 2018 were retrospectively analyzed. They were divided into group A (PFNA alone, 35 cases) and group B (PFNA combined with mini plate reconstruction of lateral femoral wall, 35 cases). There was no significant difference in the general data of gender, age, side, cause of injury, time from injury to operation between the two groups ( P>0.05). The operation time, intraoperative blood loss, fracture healing time, postoperative complications, and the tip apex distance (TAD) at 2 months after operation were recorded and compared between the two groups. Harris hip score was used to evaluate the function at 12 months after operation. Both groups were followed up 9-21 months, with an average of 16.6 months. The operation time and intraoperative blood loss in group A were significantly less than those in group B ( P<0.05); there was no significant difference in TAD between the two groups at 2 months after operation ( t=0.096, P=0.462). There were 5 complications (14.3%) occurred in group A, including 2 cases of blade perforating from the hip joint, 2 cases of screw back out, and 1 case of bone nonunion; only 1 case (2.9%) in group B had screw back out after operation; there was no significant difference in the incidence of complications between the two groups ( χ 2=2.917, P=0.088). All the fracture healed in group B, and 1 patient in group A suffered bone nonunion and eventually main nail fracture. The healing time of fracture in group A [(15.6±2.7) weeks] was significantly longer than that in group B [(12.5±2.5) weeks], showing significant difference ( t=2.064, P=0.023). At 12 months after operation, according to Harris score, the results were excellent in 5 cases, good in 9 cases, fair in 13 cases, and poor in 8 cases in group A, the qualified rate (Harris score>70) was 77.14%; and the results were excellent in 7 cases, good in 11 cases, fair in 16 cases, and poor in 1 case in group B, the qualified rate was 97.14%; there was significant difference in the qualified rate between the two groups ( χ 2=6.248, P=0.012). Compared with PFNA alone, the treatment of AO/OTA type 31-A3 intertrochanteric fracture with PFNA combined with mini plate reconstruction of lateral femoral wall can significantly reduce postoperative complications, promote fracture healing, and improve functional recovery of patients after operation.

A prospective study of functional outcome between Mini-plates and percutaneous K-wire fixation following metacarpal shaft fractures

Background: Metacarpal fractures comprise between 18–44 % of all hand fractures. Too often these metacarpal fractures are neglected or treated as minor injuries and results in major disability and deformity with permanent crippling of fine movements. A stable fracture fixation helps in restoring early mobilization. Early mobilization can prevent adhesions and is the key to good clinical outcome. Methods: Thirty six patients with metacarpal fractures were surgically fixed with k-wire or plate and screw in our trauma centre. 27 males and 9 females patients were part of the study. Radiographs of affected hand, both AP & Lateral views were obtained before surgery, post- surgery, and at follow-ups. Results: In this study, after 6 weeks of follow up it was found that metacarpal shaft fractures fixed with ORIF with mini plates show better functional outcome compared to CRIF with percutaneous K-wires. Finger stiffness being the commonly encountered complication. Conclusions: Mini-plates fixation in oblique and spiral fractures provide stable and rigid internal fixation that allows early active range of motion and early excellent results. Percutaneous K-wire fixation has the advantages of preserving the soft tissue.

Surgical Outcome of Anterior Cervical Discectomy and Fusion (ACDF) with Autologous Bone Graft from Iliac Bone and Miniplate Application Over It

Objectives: To know the surgical outcome of ACDF with autologous bone graft from iliac bone and miniplate application over it.Materials and Methods: This prospective study was conducted in the Department of Neurosurgery, Hayatabad Medical Complex and Lady Reading Hospital Peshawar from 1st June 2017 to 31 December 2018. Only those patients having prolapsed intervertebral cervical discs or cervical stenosis were included while those with multiple level involvement, trauma, fracture and previously operated patients for any cervical pathology were excluded. Pre-op and postoperative data were documented. For all patients, tricortical iliac bone autograft and rigid plate instrumentation was used to optimize fusion cervical collar was not used post op. Acquired data were analyzed with SPSS v20.Results: Total 83 patients fulfilled the inclusion criteria and enrolled in the study. Out of these, 48 patients were males and 35 were females. The age range was from 17 to 63 with a mean age 52 years ± 2.5.The C5 – C6 was the commonest site for fusion C6 – C7, C3 – C4 and C4 – C5 were less common. Odom’s criteria was applied to determine the outcome of the procedure. Excellent results were noted in 70 (82%). Ten (12.05%) patients had good results. Conclusion: The ACDF with the tricortical iliac bone autograft and mini plate application is the choice treatment in appropriately selected patients. It increases chances of fusion and abates the need for post op cervical collar.

Evaluation of Efficacy of Various Fixation Devices in Management of Anterior Mandibular Fractures: A Prospective Clinical Study

Aim: The aim of this study was to evaluate the efficacy and reliability of fracture management in the anterior mandible using miniplates (MPs), lag screws (LSs), three-dimensional (3D) plates, and Herbert screws. Materials and Methods: The study consists of forty patients randomly divided into four groups of ten, undergoing open reduction internal fixation of anterior mandible fractures using MPs, LSs, 3D plates, or Herbert screw. All the patients were evaluated for stability of fracture fragments, duration of procedure, requirement of maxillomandibular fixation, and other associated complications. Results: The results of this study showed that each fixation device has its own merits and demerits. The rectangular plates achieved good stability, but its placement and adaptation was challenging in certain clinical scenarios when the anterior mandibular height was less, especially in females and in situations where the fracture line was in close proximity to the mental foramen. The placement of LS and Herbert screw was technique sensitive but did achieve good initial stability in addition to shortening the procedure time. The MPs were more versatile but required more operating time and hardware for the management of the anterior mandibular fractures. Conclusion: All of these modalities were able to achieve satisfactory final outcome. The rigid fixation techniques achieved similar results with less hardware and required lesser times. The MP fixation techniques, on the other hand, are more versatile and less technique sensitive.

Reduction of morbidity of the revascularization surgery in the management of mandibular osteoradionecrosis by basilar edge preservation

IntroductionThe chronic complications of bone free-flap revascularization surgery are mainly characterized by skin fistulization of the osteosynthesis material, which sometimes leads to reactivation of the osteoradionecrotic phenomenon. The objective of the study is to evaluate the benefit of mandibular basilar edge preservation in bone reconstructive surgery in irradiated areas performed for the treatment of advanced mandibular osteoradionecrosis. Materials and methodsA retrospective monocentric study conducted between 2003 and 2018 including all patients undergoing revascularization surgery for the treatment of advanced osteoradionecrotic lesion with respect to the basilar margin was conducted. ResultsEight patients (7 males and 1 female, aged 50 to 63 years) who had a marginal mandibulectomy with reconstruction by bone free flap or composite free flap were included. The stability of the reconstruction (junction native mandible/bone free flap) was achieved on average by using 1.75 [range 0–4] mini plates (Medartis® Modus 2.0, Medartis AG, Basel, Switzerland). During the follow-up (30±13 months) no chronic complication related to a dissociation of the osteosynthesis material or a reactivation of the osteoradionecrotic phenomenon were identified. ConclusionsDespite the limited number of patients, it seems that the increase in the friction surface between the free flap and the native mandibular bone, linked to the preservation of the basilar edge, improves the primary stability of the reconstruction. This reduction in mechanical stress on osteosynthesis materials limits its use and reduces the rate of chronic complications of bone flap revascularization surgery in irradiated areas.

Evaluation of different stable internal fixation in unfavorable mandible fractures under finite element analysis.

The mandibular angle fracture is the most common fracture between this type of injury in jaw bone and also is the type of fracture treatment that presents a larger number of complications, and a series different osteosynthesis types have been studied over the years by the world literature. The finite element method is a form of mathematical analysis, which is based on dividing a structure into a finite number of small areas. It has the ability tomathematically model structures, making it possible to apply forces anywhere. For this study, a three-dimensional mandible with an unfavorable angle fracture was simulated. Five different types of fixations were evaluated: group 1, Champy technique with one 4-holes miniplate, 2.0 system; group 2, technique with two parallel 4-holes conventional miniplates, 2.0 system; group 3, technique with two parallel 4-holes locking miniplates, 2.0 system; group 4, technique with one reconstruction 6-holes plate, 2.8 system in base jaw; and group 5, technique with one reconstruction 6-holes plates, 2.8 system in jaw body + one parallel 4-holes conventional miniplate, 2.0 system. The results showed that strains are better distributed through the locking miniplate and screws system and presented less stress concentration when compared with the conventional ones. The Champy technique had the worst results about of all groups. The use of the locking system shows less stress compared to the non-locking system, and the presence of a reconstruction plate associated with a mini plate does not lead to increased stability compared with an isolated reconstruction plate.

Application of mini plate through modified anteromedial approach of elbow joint for the treatment of ulna coracoid process fractures

目的 探讨改良前内侧入路微型钢板内固定治疗尺骨冠状突骨折的效果。 方法 自2015年1月至2018年3月采用改良前内侧入路微型钢板手术治疗10例尺骨冠状突骨折患者。男6例，女4例；年龄25~51岁，平均35.5岁。尺骨冠状突骨折按Regan-Morrey分型标准：Ⅰ型骨折2例，Ⅱ型骨折5例，Ⅲ型骨折3例。均采用微型钢板内固定治疗。采用Mayo肘关节功能评分评定肘关节功能。 结果 术后10例患者均获得随访，时间6~24个月，平均12.1个月。所有患者的骨折均愈合，愈合时间12~17周，平均14.5周。根据Mayo肘关节功能评分：优6例，良3例，可1例。所有患肢均无肘关节屈伸及内外翻不稳定，无异位骨化。 结论 改良前内侧入路微型钢板内固定治疗尺骨冠状突骨折，有暴露充分、内固定牢固可靠、创伤小、临床效果良好等优点。

Fixation of the Various Coronal Plane Fracture Fragments, Including the Entire Coronoid Process, in Patients with Mayo Type IIB Olecranon Fractures - Four Methods for Fixation.

Background:We introduce several methods for fixation of unique Mayo type II olecranon fractures with the coronal plane fragment (CPF) including the entire coronoid process and report the radiological and clinical results through a case series.Materials and Methods:12 patients were operated using this method with a mean age of 44 years. CPFs were fixed with concurrent fixation by a locking plate screw for the olecranon in three patients (method 1), cerclage wiring in six patients (method 2), a mini plate in two patients (method 3), and a double-locking plate (method 4) in one patient. We accessed the fragment through an additional medial coronoid approach after identifying the olecranon fragment through a dorsal approach (methods 1–3). In method 4, the CPF was fixed through a dorsal approach between the comminuted metaphyseal fragments.Results:With the exception of one patient with delayed union, all patients had achieved union at 3-month followup. The mean flexion extension arc was 125°. The mean pronation/supination was 72.5°/71.7° (range, 60-80°/60-80°). The mean visual analog scale score for elbow pain was 0.92 (range, 0-2), and the mean Mayo Elbow Performance Score was 86.7 (range, 80-90). The mean Disabilities of the Arm, Shoulder, and Hand score was 10.2 (range, 4-14). There were no major complications.Conclusion:A thorough preoperative understanding of the fragment patterns and preparation of tools for adequate reduction and fixation are necessary for satisfactory clinical and radiological outcomes. However, further comparative trials of conservative management versus surgery for CPF fixation, and any differences in outcomes according to the CPF fixation options, are required.

CONDYLAR FRACTURE;

Background: This study was conducted tocompare treatment outcomes of condylar fracture fixation usingeither single or double non-compressive mini plates. Study Design: Interventional study. Setting: Department of Oral and Maxillofacial Surgery, Dr. IshratulIbad Khan Institute of Oral Health Sciences, Dow University of Health Sciences. Period: July 2017 till December 2017. Materials and Methods: A total of 30 participants were selected and randomly divided into 2 groups, each consisting of 15 participants.Patients treated with a single non-compression miniplate were placed in group 1, while those patients whose fractures were reduced and fixed by double non-compression mini plates were placed in group 2. Outcomes assessed were intraoperative time, deviation on mouth opening, malocclusion, plate bending, function of facial muscles and the relative cost of implants. Results: Out of a total of thirty patients, it was observed that those patients who were randomly assigned group 2 had better treatment outcomes and less complications as compared to the other group. Three patients with malocclusion were seen in group 1 compared with only a single case seen in group 2. Greater number of plate bending with susceptibility to plate fracture was also observed in Group 1. Conclusion: It can thus be concluded that using two plates for condylar fracture represents a more stable and sustainable solution with less complications in providing osteosynthesis.

A Comparative Evaluation between Fixation Techniques Using Lag Screws and Mini Plates in the Treatment of Parasymphysis Fracture

A Comparative Evaluation between Fixation Techniques Using Lag Screws and Mini Plates in the Treatment of Parasymphysis Fracture

Application of mini hook plate in the treatment of acute ulnar avulsion fracture at the base of proximal phalanx of thumb

Objective To evaluate the clinical outcomes of mini hook plate in the treatment of acute ulnar avulsion fracture at the base of proximal phalanx of thumb. Methods From February 2015 to February 2016, 20 cases of acute ulnar avulsion fracture at the base of proximal phalanx of thumb were treated by open reduction and mini hook plate fixation to correct the fracture deformity and reconstruct the collateral ligament attachment. Results All the patients were follow-up for 6 to 24 months with an average of 16.2 months. The time of fracture healing ranged from 4 to 7 weeks, averaging 5.2 weeks. According to Saetta functional assessment standard, the results were graded as excellent in 14 cases, good in 5 cases, and fair in 1 case. X-rays showed the line of avulsion fracture disappeared. Conclusion Application of mini hook plate in the treatment of acute ulnar avulsion fracture at the base of proximal phalanx of thumb can achieve strong fixation and lead to satisfactory postoperative function recovery of the first metacarpophalangeal joint. The clinical outcomes are reliable. Key words: Finger phalanges; Fracture fixation, internal; Metacarpophalangeal joint; Mini plate

Direct anterior approach for mini plate fixation of Regan–Morrey type II comminuted ulnar coronoid process fracture

The goal of this study was to evaluate the clinical effect of Regan-Morrey type II comminuted coronoid process fracture treated with mini plate through the direct anterior approach (DAA). Ten patients who underwent open reduction and internal fixation (ORIF) with mini plate through the DAA between February 2013 and August 2016 was included. There were three women and seven men, with an average age of 34.4 ± 7.5 years. At the final follow-up, the Mayo Elbow Performance Index (MEPS), Visual Analogue Scale (VAS) score, Disability of the Arm, Shoulder, and Hand (DASH) score, and the elbow range of motion were noted. The mean follow-up was 26.3 ± 2.2 (range 24-31) months. The mean elbow arc of motion was 118.5° with a mean arc of extension of 4° ± 5.2° and flexion of 122.5° ± 7.2°.The mean forearm pronation was 72° ± 7.2°, and the mean supination was 68° ± 6.3° with a mean forearm rotation arc of 140°. The average postoperative score according to the MEPS was 91 ± 5.7 points (range 80-100 points), and all patients achieved satisfactory scores (8 excellent and 2 good). The final average VAS score was 0.6 ± 1 (range 0-3). The final average DASH score was 4.0 ± 1.6 (range 2.3-7.4). None of the patients complained about elbow instability that required secondary surgery. No complications of infection, joint incongruency, fracture nonunion, median nerve palsy, or implant failure were reported. ORIF with mini plate through the DAA for the treatment of the type II comminuted coronoid process fractures can achieve satisfactory outcomes.

Investigation the effect of angle of monocortical screw placement on the stability miniplates in the fractures of the sheep mandibular bone

The proper design of the screw and plate placement relative to each other in order to prevent the driving the screw out of the bone, maintain the integrity of the screw-plate and create a more robust system in order to improve the plate function are important in the treatment of fractures or abnormalities surgery of mandibular bone using screw and plate. As regards, no study so far has been done about the change in the angle of monocortical screw placement relative to the miniplates in these surgeries; the aim of this study is the investigation of the effect of the angle of monocortical screw placement in the miniplate stability in created fractures of sheep mandibular bone. 30 hemi-mandibles were cut from the mandibular angle and two pieces of bone were again fixed to the same position with a mini plate and in each sample with one of three angle of monocortical screw (45, 60, and 90�) relative to mini plates. Afterwards, mandibles were fixed in the universal testing machine that is used for tensile and shear tests. There were a significant difference between the mean tolerated tensile forces at the angle of 45 and 60 degree and at the angle of 45 and 90 degree. On the other hand, there was not a significant difference between the mean tolerated tensile forces at the angle of 60 and 90 degree. It seems that in cases where the surgeon faces with limited access during surgery or screw placement path interference with important anatomical elements, he can use a 60 degree screw angle

A retrospective cross-sectional study of maxillofacial trauma in Delhi-NCR Region.

Aim and Objectives:To evaluate the pattern, prevalence, etiology, site of fractures, and their management in patients with maxillofacial injury in Delhi-NCR region.Materials and Methods:A total of 1278 maxillofacial trauma patients visiting different registered hospitals from Delhi-NCR region from January 2012 to December 2017, treated by open reduction and internal fixation under general anesthesia (GA)/local anesthesia (LA) or closed reduction/conservatively, were taken into the study. The parameters considered in the study were age and sex distribution, etiological factors and incidence of maxillofacial trauma, pattern and site distribution of maxillofacial fractures, and management.Results:From a total of 2250 trauma patients, 1278 patients (1053 males and 225 females) had maxillofacial injury. The average prevalence rate was 56.8%. Yearly incidence rate was 20.4%. Road traffic accident (RTA) was the most common cause of trauma in 1029 (80.5%) patients, followed by physical assault [158 (12.3%)] with significant male predominance in different age groups. Isolated mandibular fractures were the most common [48.6% (parasymphysis 31.6%, condyle 28.2%)], followed by midface with maxilla fracture [27.6% (zygomatic bone and arch 50.2% and Lefort II fractures 18%)]. Treatment modalities were conservative management, closed reduction, and open reduction with internal fixation under GA/LA.Conclusion:RTA followed by physical assault is still the leading cause of maxillofacial trauma in young males in Delhi-NCR region. Mini plate osteosynthesis is the main treatment procedure for maxillofacial trauma. We need to enforce strict traffic rules, road safety law, and preventive measures along with improvement in education and socioeconomic status in the population to avoid maxillofacial injuries.

Biomechanical evaluation of double Y-shaped versus conventional straight titanium miniplates for the treatment of mandibular angle fractures

Aim of this experimental study: Was to test the resistance to mechanical force of a doubleY- shaped titanium miniplate versus conventional straight titanium miniplate for the treatment ofmandibular angle fracture.Materials and methods: Ten fresh sheep hemi mandibles, sectioned at the angle region, wereused to evaluate two plating techniques. One group (Group A) received fixation via a double Yshapedtitanium miniplate and the second group (group B) via a six-hole conventional straightnon-compression titanium miniplate .Each hemi mandible in group A and group B was subjected totensile forces using universal testing machine.Results: During the test, the group (A) fixed by double Y-shaped miniplate, the plates werefractured in all group samples at mean of the Yield load (745N). The mean degree of displacementof this group was 7.8mm). While in group (B), the conventional straight titanium mini plates werefractured at force (the mean; 665.6N). The mean of degree of displacement of this group was7.8mm)Conclusion; Double Y-shaped miniplate with 6 holes and 9.0 mm spacing had greater resistanceto displacement and provided more favorable biomechanical behavior than the conventional straightminiplates in the repair of mandibular angle fractures.

Combined ulnar shortening osteotomy and elastic suspended fixation in treatment of ulnar impaction syndrome

To investigate the effectiveness of ulnar shortening osteotomy combined with elastic suspension fixation for ulnar impaction syndrome caused by relatively long ulna. Between October 2015 and August 2016, 3 cases of ulnar impaction syndrome were treated. One patient was male and 2 patients were females. The age was 32, 29, and 59 years, respectively. One patient was dislocation and impaction of distal radioulnar joint for more than 1 year after internal fixation due to ulnar and radial open fractures. Other patients had no trauma and surgery, but long-term manual history. The visual analogue scale (VAS) scores were 7, 5, and 5, respectively. Cooney wrist function scores were rated as poor. Preoperative X-ray measurements of the ulnar variance was 12.7, 9.0, and 8.7 mm, respectively. The ulna was transversely osteotomy and fixed with plate and screws. The distal radioulnar joint was elastic suspension fixed with mini plate. Postoperative X-ray film showed that the matching of the distal radioulnar joint had no significant difference compared with the contralateral side. All the incisions healed by first intention without complication such as neurovascular injury, infection, and dislocation of the distal radioulnar joint. The patients were followed up 27, 17, and 23 months, respectively. At last follow-up, X-ray film showed that all osteotomy segments achieved bony union without internal fixation failure. The VAS scores were 2, 0, and 1, respectively, and the Cooney wrist function scores were rated as excellent. The ulnar shortening osteotomy combined with elastic suspension fixation can correct the ulna variation, avoid the instability of the distal radioulnar joint caused by the extensive dissection of the tissue around the ulnar, and avoid stiffness of the joints caused by rigid fixation. It is an ideal treatment for ulna impaction syndrome.

Mini-plate fixation via sinus tarsi approach is superior to cannulated screw in intra-articular calcaneal fractures: A prospective randomized study

Intra-articular displaced calcaneal fractures are common fractures and are often treated with surgical interventions. Sinüs tarsi approach provides secure access to lateral wall and joint facets. The aim of the study is to compare cannulated screw (CS) fixation and mini-plate (MP) fixation via sinus tarsi approach with Sanders types 2 and 3 fracture of calcaneus. Sixty patients with Sanders types 2 and 3 calcaneal fracture underwent surgical intervention were randomly allocated into two groups as group MP fixation and group CS fixation regarding osteosynthesis method for 5-year period. Open reduction via sinüs tarsi approach was performed in both groups. Demographic variables, time to surgery (TS), operation duration (OD), length of hospital stay (LOS), surgical complications, and reoperations were recorded. Pre- and postoperative Gissane and Böhler angles; calcaneal length, height, and width; ankle anterior-posterior (AP) and lateral X-rays; and computed tomography were also recorded for radiological evaluation and fracture characteristics. Maryland Foot Score (MFS) was used to evaluate functional outcomes. Preoperative age, type of fracture, calcaneal length, height, and Gissane and Böhler angles, TS, LOS, and OD were not different between the groups. The postoperative calcaneal widening was significantly better restored in group MP compared with that of group CS. The incidence of reoperation and algoneurodystrophy was statistically higher in group CS than group MP. MFS in group MP was also higher than group CS at final visit. MP fixation via sinus tarsi approach is superior to CS fixation in Sanders types 2 and 3 calcaneal fractures.

Functional outcome of Metacarpal Fracture managed with Miniplate and Screws

Background and Objectives: Early techniques of splint immobilization work well for simple metacarpal fractures. However, if significantly shorting, rotational deformity, and angulations occur, surgical treatment is required. The aim of this article was to study the functional outcome of metacarpal fractures treated by open reduction and internal fixation with mini plates and screw in low resource condition of Nepal.Material and Methods: This retrospective study was done over a period of one year 2012 to 2013 in Bir Hospital, Patan hospital and Shree Birendra hospital. The functional outcome after treatment was assessed by ability to perform acts of daily life and calculating American Society for Surgery of the Hand Total Active Flexion (ASSH-TAF).Results: Out of 30 patients twenty three were male (76.7%) and seven were female (23.3%). Among them, 7 patients (23.3%) showed union in 6 weeks. 18 Patients (60%) had union in 4 weeks. 3 patients (10%) had at five weeks and 2 patients had union at 6 weeks. We observed ASSH-TAF score at 2 weeks, 1month, 3 months, and 6 months. Results showed 24 patients (80%) had excellent, 4(13.3%) had good and 2(6.7%) had poor result.Conclusion: The use of miniplate and screws is a reasonable option for treating in displaced metacarpal fracture as it provides a rigid, Secure an anatomical stable reduction, which is sufficient to allow early mobilization of the adjacent joints, hence the mini plate fixation is effective means of immobilization of fracture of metacarpal with less complication and excellent functional outcome.

Management of Metacarpal and Phalangeal Bone Fractures of the Hand

Background: Hand fractures are one of the most commonfractures presenting at accident and emergency units. Becauseof the complexity of the hand; management of hand fracturescan be very challenging. Fixation of hand fractures can bedone by multiple methods including percutaneous K-wiresfixation and open reduction and internal fixation with eitherinterosseous wiring or mini plate and screws. This comparativeclinical study is to review the indications and long term resultsof each method.Methods: Thirty patients with hand fractures were includedin our study, ten of them treated with percutaneous K wirefixation (group A), another ten patients were treated withopen reduction and internal fixation with interosseous wiring(group B)and the last ten patients were treated with openreduction and internal fixation with miniplate and screws(group C). The duration of this study was for eleven monthswith patient's age ranging from 15-50 years old. The type ofsurgical intervention used was determined according to thefracture pattern.Results: All patients treated in this study had clinical andradiological union by the 10th week. Patients treated withpercutaneous K wire fixation had better range of movementand earlier return to work with less complications than patientstreated with open reduction and internal fixation with interosseouswiring or mini-plate and screws.Conclusion: Percutaneous fixation of unstable metacarpaland phalangeal fractures is a reliable and safe method for themajority of fracture patterns with higher ROM and lesscomplications in comparison with the other two methods.

Efficacy of internal fixation with mini plate and internal fixation with hollow screw for Regan-Morrey type II and III ulna coronoid fractures

BackgroundUlna coronoid fracture is a complicated injury and occurred in the coronal plane. Undeniably, there is no universally accepted approach for treating ulna coronoid fractures. Therefore, this study aimed at exploring the efficacy of different surgical treatments for Regan-Morrey type II and III ulna coronoid fractures.MethodsA total of 164 patients with ulna coronoid fractures were admitted and treated in department of orthopedics at Yiwu Central Hospital, the Affiliated Yiwu Hospital of Wenzhou Medical University for retrospective analysis. The baseline features (age, gender, time from injury to surgery and so on) before the surgery and different conditions during the surgery were compared. Following that, the Visual Analogue Scale (VAS) pain score was employed to evaluate the severity of preoperative and postoperative pain experienced by the patients in each group. Afterwards, Broberg and Morrey elbow score was used to evaluate elbow joint function and surgical effect of the patients. Lastly, the postoperative recovery and complications were compared.ResultsIt was firstly observed that internal fixation with mini plate and hollow screw compelled to lower average operation time and blood loss than Kirschner wire and steel wire suture. Next, the severity of postoperative pain was lessened in comparison with preoperative pain. Afterwards, mini plate and hollow screw improved elbow joint function more notable than Kirschner wire and steel wire suture, and Kirschner wire and steel wire suture resulted in higher incidence of complications and worse postoperative recovery.ConclusionCollectively, this study clarified that for the treatment of Regan-Morrey type II and III ulna coronoid fractures, internal fixation with mini plate and hollow screw has an overall superior surgical effect than internal fixation with Kirschner wire and steel wire suture.