Comparative study of the clinical results of metacarpal and phalangeal fracture fixation by titanium mini-plates and cross K-wires

Objevtive To assess the clinical results of metacarpal and phalangeal fracture fixation by titanium mini-plates and cross K-wires. Methods 80 metacarpal and phalangeal fractures in 59 cases were randomly assigned to K-wire fixation group (Group A,37 fractures in 26 cases) and titanium mini-plate fixation group (Group B,43 fractures in 33 cases). Redults Podtoperatively all the cases were followed up for 3 to 12 months (average 7.6 months).The clinical results of both groups were assessed by the upper extremity functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association.In group A 13 fractures were graded as excellent,11 as good and 13 as poor.The excellent and good rate was 64.9%.In group B.26 fractures were graded as excellent,13 as good and 4 as poor.The excellent and good rate was 90.7%, being significantly better than that of group A.As for postoperative infection,it occurred in 9 fractures of group A(9/37,24.3%) and in 3 fractures of group B (3/43,7.0%),being significantly lower in group B. The average bone union time was 7.6 weeks for group A and 4.6 weeks for group B.Postoperative comptications such as joint stiffness,fracture site discomfort and tendon adhesion were fewer in group B than in group A.Conclusion Titanium mini-plate fixation is superior to cross K-wire fixation for treatment of metacarpal and phalangeal fractures when judged by such indexes as postoperative functional restoration of the metaearpophal and interphalangeal joints,postoperative infective rate,average fracture union time and complication rate. Key words: Metacarpal bones; Finger phalanges; Fracture fixation; Treatment outcome