Ahmed Zulfiqar, Haider Muhammad Imran, Buzdar M Iqbal, Bakht Chugtai Babar, Rashid Majid, Hussain Nazar, Ali Farman
Orthopaedics, Bahawal Victoria Hospital, Bahawalpur, PAK.
Orthopaedics, Sahiwal Medical College, Sahiwal, PAK.
Cureus. 2020 Feb 19;12(2):e7039. doi: 10.7759/cureus.7039.
Introduction Metacarpal and phalangeal fractures are common upper limb fractures due to direct blows, axial loading, and torsional loading injuries. The universal goal in treating all fractures for the patient to achieve normal motion, but the ideal technique for stabilization is still debated. For internal fixation, Kirschner wires (K-wires) or miniplates can be used, and each carries certain advantages. No previous study has compared K-wire use to miniplate use in treating metacarpal and phalangeal fractures. Therefore, we conducted this randomized control trial to evaluate the outcomes of K-wire and miniplate use in treating metacarpal and phalangeal fractures. Materials and methods This randomized controlled trial was conducted in the Department of Orthopaedic Surgery, Bahawal Victoria Hospital, from February 2017 to February 2018. Seventy-five patients were included in this study and randomly assigned into two groups. One group was treated with K-wire fixation, and the other group was treated with miniplate fixation. We assessed total active motion (TAM), range of motion (ROM), duration of injury, and complication rate. Data were analyzed using IBM SPSS Statistics for Windows, Version 23.0 (Armonk, NY: IBM Corp). P values ≤ 0.05 were considered significant. Results Mean surgical time, pain scale, and time of union of K-wire treated patients was 38.63±3.64 minutes, 4.17±1.11, and 12.95±3.38 weeks, respectively. The success of the union was noted in 38 K-wire patients (95%). Total active ROM was greater in miniplate fixation patients compared with K-wire treated patients, but this difference was statistically significant. Similarly, TAM was also greater in the miniplate fixation patients compared to the K-wire treated patients, but this difference was also not statistically significant. Conclusion Both K-wire fixation and miniplate fixation are equally effective in terms of TAM, ROM, and complications when used to treat metacarpal and phalangeal fractures.
引言
掌骨和指骨骨折是上肢常见骨折，多由直接打击、轴向负荷和扭转负荷损伤所致。治疗所有骨折的共同目标是让患者实现正常活动，但稳定骨折的理想技术仍存在争议。对于内固定，可使用克氏针（K 针）或微型钢板，且每种方法都有一定优势。此前尚无研究比较 K 针与微型钢板在治疗掌骨和指骨骨折中的应用。因此，我们开展了这项随机对照试验，以评估 K 针和微型钢板治疗掌骨和指骨骨折的效果。
材料与方法
本随机对照试验于 2017 年 2 月至 2018 年 2 月在巴哈瓦尔维多利亚医院骨科进行。本研究纳入了 75 例患者，并随机分为两组。一组采用 K 针固定治疗，另一组采用微型钢板固定治疗。我们评估了总主动活动度（TAM）、活动范围（ROM）、损伤持续时间和并发症发生率。数据使用 IBM SPSS Statistics for Windows，版本 23.0（纽约州阿蒙克：IBM 公司）进行分析。P 值≤0.05 被认为具有统计学意义。
结果
K 针治疗患者的平均手术时间、疼痛评分和愈合时间分别为 38.63±3.64 分钟、4.17±1.11 和 12.95±3.38 周。38 例 K 针治疗患者（95%）实现了愈合。微型钢板固定患者的总主动 ROM 大于 K 针治疗患者，但这种差异无统计学意义。同样，微型钢板固定患者的 TAM 也大于 K 针治疗患者，但这种差异也无统计学意义。
结论
在治疗掌骨和指骨骨折时，K 针固定和微型钢板固定在 TAM、ROM 和并发症方面同样有效。
