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Arch Hand Microsurg > Volume 23(4); 2018 > Article
Archives of Hand and Microsurgery 2018;23(4):230-238.
Published online December 1, 2018.
DOI: https://doi.org/10.12790/ahm.2018.23.4.230   
Comparative Analysis of Fracture Angulation between Parallel Pinning and Plate Fixation Techniques in the Management of 5th Metacarpal Fractures
Myungchul Lee, Hyojung Shin, Hyungon Choi, Jeenam Kim, Donghyeok Shin
Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Seoul, Korea. sdhplastic@kuh.ac.kr
Received: 11 September 2018   • Revised: 1 October 2018   • Accepted: 3 October 2018
Abstract
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.
Key Words: Metacarpal bones, Fracture, Angulation, Closed fracture reduction, Open fracture reduction
 


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