Comparison of the clinical effects of mini phalangeal external fixation and mini plate in the treatment of the metacarpal bone head intraarticular fractures

Objective To compare the clinical effects of mini phalangeal external fixation and mini plate in the treatment of intraarticular fractures of the metacarpal bone head, and to provide a theoretical basis for clinical selection of surgical plan. Methods Seventy-four cases of metacarpal bone head intraarticular fractures treated in Huizhou People′s Central Hospital from March 2014 to March 2016 were selected as the research object.All cases were closed fractures and were randomly divided into the external fixation group and the mini plate group, 37 cases in each group and treated respectively with the mini phalangeal external fixator and mini AO plate.The patients were followed up for 6 months to 1 year, the function of the metacarpophalangeal joint, the union of the fracture and the incidence of side effects were compared between the two groups. Results The excellent rates of the external fixation group at 6 months and I year after operation were 91.9% (34/37) and 97.3%(36/37) respectively, which were significantly higher than those of the mini plate group (73.0%(27/37), 81.2%(30/37) ), the difference was statistically significant (χ2=7.120, 7.062, P<0.05). The complication rate of the external fixation group was 2.7%(1/37), which was significantly lower than that of the mini plate group (24.3% (9/37) ), the difference was statistically significant (P=0.014). The average fracture healing time in the external fixator group was (2.6±0.4) months, which was significantly lower than that in the mini plate group (3.1±0.7) months, the difference was statistically significant (t=2.40, P<0.001). Conclusion In the treatment of metacarpal bone head fracture, the external fixation has small trauma, can do cross joint fixation, and maintain a good fixation strength, and promote the healing of fracture and the recovery of metacarpophalangeal joint function.It is worthy of clinical application. Key words: Mini plate; External fixation; Fracture of metacarpal bone head