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KMID : 1143020180230040230
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Archives of Hand and Microsurgery
2018 Volume.23 No. 4 p.230 ~ p.238
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Comparative Analysis of Fracture Angulation between Parallel Pinning and Plate Fixation Techniques in the Management of 5th Metacarpal Fractures
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Lee Myung-Chul
Shin Hyo-Jung
Choi Hyun-Gon
Kim Jee-Nam
Shin Dong-Hyeok
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Abstract
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Purpose: Metacarpal fractures are common injuries of the hand. They are treated using closed reduction (CR) or open reduction (OR) techniques. The management strategy depends on fracture site characteristic and fixation methods. In this study, we evaluated pre- and postoperative fracture angulation, when metacarpal fractures bad been treated using two different techniques: CR with parallel transverse pinning and OR with plate fixation.
Methods: Forty-six patients undergoing anatomic reduction to treat extra-articular metacarpal fractures were recruited. They were included in one of two therapeutic groups: Group 1, CR with parallel transverse pinning (n=21); Group 2, OR with plate fixation (n=25). Fracture angulation values have been measured on pre- and postoperative radiologic images. Values were compared between pre- and postoperative states, and between corresponding measurements of each group.
Results: All extra-articular metacarpal fractures were successfully treated without wound related complications or the limit of joint motion. Both groups demonstrated adequate reduction at immediate postoperative period (postoperative angulation of group 1, 20°±7°; group 2, 19°±5°). During the observation at follow-up period, Group 1 exhibited slight recurrence (follow-up angulation of group 1, 24°±10°). Nonetheless, Group 2 showed adequate reduction state in both immediate postoperative and long-term follow-up periods (follow-up angulation of group 2, 18°±6°).
Conclusion: Extra-articular metacarpal fractures were successfully restored without functional complications. CR with parallel transverse pinning method exhibited recurrence after pin removal, which necessitates cautious postoperative exercise and monitoring.
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KEYWORD
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Metacarpal bones, Fracture, Angulation, Closed fracture reduction, Open fracture reduction
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