scholarly journals Controlled active exercise after open reduction and internal fixation of hand fractures

2021 ◽  
Vol 48 (1) ◽  
pp. 98-106
Author(s):  
Dongkeun Jun ◽  
Jaehyun Bae ◽  
Donghyeok Shin ◽  
Hyungon Choi ◽  
Jeenam Kim ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Axial Loading ◽  
Early Postoperative Period ◽  
Radiographic Images ◽  
Metacarpal Fractures ◽  
Hand Fractures ◽  
Metacarpal Bones ◽  
Functional Exercise

Background Hand fractures can be treated using various operative or nonoperative methods. When an operative technique utilizing fixation is performed, early postoperative mobilization has been advocated. We implemented a protocol involving controlled active exercise in the early postoperative period and analyzed the outcomes.Methods Patients who were diagnosed with proximal phalangeal or metacarpal fractures of the second to fifth digits were included (n=37). Minimally invasive open reduction and internal fixation procedures were performed. At 3 weeks postoperatively, controlled active exercise was initiated, with stress applied against the direction of axial loading. The exercise involved pain-free active traction in three positions (supination, neutral, and pronation) between 3 and 5 weeks postoperatively. Postoperative radiographs and range of motion (ROM) in the interphalangeal and metacarpophalangeal joints were analyzed.Results Significant improvements in ROM were found between 6 and 12 weeks for both proximal phalangeal and metacarpal fractures (P<0.05). At 12 weeks, 26 patients achieved a total ROM of more than 230° in the affected finger. Postoperative radiographic images demonstrated union of the affected proximal phalangeal and metacarpal bones at a 20-week postoperative follow-up.Conclusions Minimally invasive open reduction and internal fixation minimized periosteal and peritendinous dissection in hand fractures. Controlled active exercise utilizing pain-free active traction in three different positions resulted in early functional exercise with an acceptable ROM.

Open Reduction and Internal Fixation Using Plate and Screws Versus Percutaneous Kirschner Wires Fixation for Second and Third Metacarpal Bones Fractures: A Meta-analysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Karim Samir Masoud ◽  
Ahmad Fathi El Sherif ◽  
Raghda Elsayed Tallal ◽  
Mahmoud Mahrous Mohamed Waly
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Functional Results ◽  
Kirschner Wires ◽  
Metacarpal Fractures ◽  
Metacarpal Bones ◽  
Surgical Fixation ◽  
Type Of Fracture

Abstract Background Metacarpal fractures are among the most common fractures of the skeletal system and account for 36 % of hand and wrist fractures. Aim of the Work To determine the functional outcome and postoperative complications for both these surgical techniques in the treatment of second and third metacarpal bones fractures. Patients and Methods The systematic review was restricted to clinical studies of both these surgical techniques in the treatment of closed second and third metacarpal fractures. We reviewed studies that include management of metacarpal fractures with open reduction and internal fixation using plate and screws versus percutaneous crossed Kirschner wires fixation. Results No specification was made about the type of fracture, other than shaft fractures located in the second and the third metacarpal. All fractures were operated because of instability, angulations’ or rotational deformity. No comparison can therefore be made between fracture type (i.e. spiral, oblique) and functional results. As all studies reported identical indication for surgical fixation a comparison between type of fixation and functional result can be made. Conclusion Based on the reported results there is no evidence to suggest one fixation technique over another. The reported complications however for ORIF and K-wire fixation in the treatment of metacarpal fractures are unmistakably different for the two types of fixation.

scholarly journals Fractures of metacarpal bone: evaluation of functional outcome of open reduction and internal fixation with mini locking plate: a hospital based study

2019 ◽  
Vol 5 (3) ◽  
pp. 519
Author(s):  
Arumugam A. Kandasamy ◽  
Mozammil Pheroz ◽  
Arvind Kumar ◽  
L. G. Krishna ◽  
Ankit Jain ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Locking Plate ◽  
Delayed Union ◽  
Rigid Fixation ◽  
Functional Evaluation ◽  
Metacarpal Fractures ◽  
Surgical Methods ◽  
Metacarpal Bones

<p class="abstract"><strong>Background:</strong> Metacarpal bones fracture is very common. Management of metacarpal fractures varies from conservative to percutaneous pinning to various surgical methods. We endeavour to evaluate the functional outcome of metacarpal fractures in patients managed with open reduction and internal fixation with mini locking plate.</p><p class="abstract"><strong>Methods:</strong> A total of 32 patients with extra-articular metacarpal bones fracture were recruited for the study. After open reduction the fractures were fixed with the mini locking plate, postoperative day 3, plaster removed and active and passive exercises started. The Michigan hand score was used for functional evaluation, grip strength, visual analogue scale score, range of motion evaluated at follow up till six months.<strong></strong></p><p class="abstract"><strong>Results:</strong> All the 32 patients achieved union, 31 had full union at 6 weeks whereas 1 patient has delayed union. The Michigan hand outcome questionnaire score of 97.5 % at 6 months in all 32 patients. A total of 5 out of 32 patients had complications, the most common being finger stiffness followed by superficial infection and delayed union.</p><p class="abstract"><strong>Conclusions:</strong> We concluded that metacarpal plating with mini locking plate is a good option to achieve and maintain a rigid fixation and this method produces a better outcome in unstable fractures of metacarpal bones.</p>

scholarly journals Re-operation for tendon adhesions following open reduction and internal fixation of metacarpal fractures

Injury Extra ◽  
2010 ◽  
Vol 41 (12) ◽  
pp. 160 ◽  
Author(s):  
S. Syed ◽  
R. Mohammed ◽  
S. Hussain ◽  
M. Waldram ◽  
D. Power ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Metacarpal Fractures

scholarly journals Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis and Open Reduction Internal Fixation on Proximal Humeral Fracture in Elder Patients: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Zhao ◽  
Yuhui Zhang ◽  
Dongni Johansson ◽  
Xingyu Chen ◽  
Fang Zheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humeral Fracture ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Humeral Fracture ◽  
Open Reduction Internal Fixation ◽  
Elder Patients

Objective. The study aims to compare minimally invasive percutaneous plate osteosynthesis (MIPO) and open reduction internal fixation (ORIF) in the treatment of proximal humeral fracture in elder patients. Method. PubMed, Medline, EMbase, Ovid, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wangfang, and VIP Database for Chinese Technical Periodicals were searched to identify all relevant studies from inception to October 2016. Data were analyzed with Cochrane Collaboration’s Review Manage 5.2. Results. A total of 630 patients from 8 publications were included in the systematic review and meta-analysis. The pooled results showed that MIPO was superior to ORIF in the treatment of proximal humeral fracture in elder patients. It was reflected in reducing blood loss, operation time, postoperative pain, or fracture healing time of the surgery and in improving recovery of muscle strength. Concerning complications, no significant difference was seen between MIPO and ORIF. Conclusion. The MIPO was more suitable than ORIF for treating proximal humeral fracture in elder patients.

scholarly journals Outcome of Internal Fixation of Metacarpal Fractures of Hand at a Tertiary Care Hospital, Kathmandu

2019 ◽  
Vol 21 (1) ◽  
pp. 35-39
Author(s):  
Praphulla Shrestha ◽  
SR Paudel ◽  
P Chalise
Keyword(s):  
Pain Relief ◽  
Internal Fixation ◽  
Tertiary Care ◽  
Kirschner Wire ◽  
The Body ◽  
Care Hospital ◽  
Metacarpal Fractures ◽  
Active Flexion ◽  
Hand Fractures

Hand fractures are different from other fractures elsewhere in the body. Functional impairment of hand leads to a prominent issue to the patient. We have a common practice of treatment of hand fractures by using kirschner wire(s). The internal fixation using plates and screws for metacarpal fractures of the hand is technically demanding but it is beneficial to the patients as it permits early mobilization and better pain relief. We studied the outcome of this type of internal fixation of the metacarpal fractures at Nepal Medical College. We included 26 patients above 18years with isolated extraarticular, closed and open Swanson I metacarpal fractures of the hand. Fractures with rotation of the digit and unacceptable angulation, shortening and unstable fractures were included. Pain was evaluated by visual analogue scale and function using American Society for Surgery of hand Total Active Flexion (ASSHTAF) score. The mean pain score (VAS) was 0.27 at 12 weeks. The ASSHTAF score showed excellent results in 92.3% patients at 12 weeks. At the final follow up 92.3% patients had excellent results, 3.8% had good and 3.8% had poor results. Fracture union was seen in all patients at final follow up. The study shows that internal fixation of unstable metacarpal fractures gives significant pain relief to the patient and an excellent functional outcome.

scholarly journals Early Experience with Low Profile Plate Osteosynthesis for Metacarpal Fractures

1970 ◽  
Vol 7 (1) ◽  
pp. 19-24
Author(s):  
A Joshi ◽  
BR K.C. ◽  
P Chand ◽  
BB Thapa
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Open Reduction Internal Fixation ◽  
Complication Rates ◽  
Metacarpal Fractures ◽  
Active Flexion ◽  
Early Return ◽  
Early Results ◽  
Low Profile

Background: Among various fixation methods for metacarpal fractures, plate osteosynthesis is the most rigid and allows early rehabilitation leading to early return to work. Many authors have reported high complication rates and most of them were because of thick plate. The aim of this study was to report early results of plate osteosynthesis of metacarpal fractures with low profile miniplate. Methods: This was a hospital based prospective study. Unstable and irreducible fractures were managed by open reduction and internal fixation with low profile miniplate and were followed up for 6 months. The functional outcome after fracture treatment was assessed by ability to perform acts of daily life and calculating American Society for Surgery of the Hand Total Active Flexion (ASSH TAF) score. Results: There were 16 patients with 17 metacarpal fractures, 87.5% were male with mean age of 31.50±9.02 years. Fourteen (87.5%) patients could perform their activities of daily living at four weeks. The mean Total Active Flexion was 261.76±24.87 at final follow up. Fourteen (87.5%) patients had excellent, one (6.25%) good and one (6.25%) poor out come at the end of 6 months. Conclusion: Low severity metacarpal fractures can be treated successfully by open reduction internal fixation with low-profile miniplate, allowing early and safe mobilization. Key words: low-profile plate, metacarpal fractures, plate osteosynthesis   DOI: 10.3126/jnhrc.v7i1.2274 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 19-24

scholarly journals Protocol of BRICS: Brazilian multicentric pragmatic randomised trial of surgical interventions for displaced diaphyseal clavicle fracture study: MIPO versus ORIF for the treatment of displaced midshaft clavicle fractures

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052966
Author(s):  
Adriano Fernando Mendes Jr. ◽  
Rodrigo Fleury Curado ◽  
Jair Moreira Dias Jr. ◽  
José Da Mota Neto ◽  
Oreste Lemos Carrazzone ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Skin Irritation ◽  
Randomised Trial ◽  
Implant Failure ◽  
Minimally Invasive Osteosynthesis ◽  
Non Union ◽  
Clavicle Fractures

IntroductionFractures of the diaphysis of the clavicle are common; however, treatment guidelines for this condition are lacking. Surgery is associated with a lower risk of non-union and better functional outcomes but a higher risk of complications. Open reduction and internal fixation with plates and screws are the most commonly performed techniques, but they are associated with paraesthesia in the areas of incisions, extensive surgical exposure and high rates of implant removal. Minimally invasive techniques for treating these fractures have a lower rate of complications. The aim of this study is to evaluate which surgical treatment option (minimally invasive osteosynthesis or open reduction and internal fixation) has better prognosis in terms of complications and reoperations.Methods and analysisThe study proposed is a multicentric, pragmatic, randomised, open-label, superiority clinical trial between minimally invasive osteosynthesis and open reduction and internal fixation for surgical treatment of patients with displaced fractures of the clavicle shaft. In the proposed study, 190 individuals with displaced midshaft clavicle fractures, who require surgery as treatment, will be randomised. The assessment will occur at 2, 6, 12, 24 and 48 weeks, respectively. The primary outcome of the study will be the number of complications and reoperations. For sample size calculation, a moderate effective size between the techniques was considered in a two-tailed test, with 95% confidence and 90% power. Complications include cases of infection, hypertrophic scarring, non-union, refracture, implant failure, hypoesthesia, skin irritation and shoulder pain. Reoperations are defined as the number of surgeries for pseudoarthrosis, implant failure, infection and elective removal of the implant.Ethics and disseminationStudy approved by the institutional ethics committee (number 34249120.9.0000.5505—V.3). The results will be disseminated by publications in peer-reviewed journals and presentations in medical meetings.Trial registration numberRBR-3czz68)/UTN U1111-1257-8953.

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