Outcome of internal fixation procedure: miniplate vs cross K wires for displaced metacarpal metaphyseal fracture

Background: Metacarpal fractures are considered a frequent orthopedic injury seen commonly in emergency units. Objectibe of thestudy was to compare the outcome of internal fixation procedure of miniplate versus cross kirschner wires (k-wires) for displaced metacarpal metaphyseal fractures.Methods: In this experimental prospective study, 100 patients with metacarpal metaphyseal fracture were considered. internal fixation was done by miniplate in one group and cross k wires in other group. Outcomes in terms of radiological union were compared between both groups. The data was analyzed by using SPSS for windows (version 26.0).Results: Mean age of the patients was 38.70±13.61 years. Male to female ratio of the patients was 1.2:1. The radiological success was noted in 76 (76.0%) patients. Statistically insignificant difference was found between the study groups in terms of radiological success of the patients (p=0.6396). K wire fixation was recorded to have significantly shorter duration of operation time in comparison to miniplate fixation (p=0.0001).Conclusions: The internal fixation procedure of both miniplate and k wire are equally effective in terms of radiological success for management displaced metacarpal metaphysis fractures. As compared to miniplate fixation, K wire fixation was found to have significantly shorter duration of operation time.

Quadrangular Fixation of Pectus Bars to Prevent Displacement in Nuss Procedure

Background Double pectus bars are sometimes inserted to correct pectus excavatum. Method of double-bar fixation to prevent bar displacement has been rarely reported. We have used quadrangular fixation of the double pectus bars. The objective of this study was to compare results of the quadrangular fixation procedure with those of the classic separate fixation procedure. Methods From September 2011 to January 2016, 86 patients underwent Nuss procedure with double-bar insertion. In 44 patients, each bar was fixed separately (group A). In 42 patients, quadrangular fixation of the bars was performed with metal plates (group B). Patient demographics, Haller index (HI), bar displacement index (BDI), and reoperation rate were compared between the two groups. Results The mean patient age was 17.2 years (range: 3–40 years) in group A and 17.8 years (range: 4–30 years) in group B. There was no significant difference in preoperative or postoperative HIs between the two groups (all p >0.05). Early complication rates were 15.9% in group A and 9.5% in group B (p > 0.05). In group A, three patients underwent surgery to correct bar displacement (6.8% of reoperation rate), whereas there was no corrective surgery in group B. BDIs of the two groups were significantly different (p < 0.01). Conclusions When quadrangular fixation was performed with upper and lower pectus bars bilaterally fixed by connecting each bar with plates, bar displacement was prevented more effectively than separate fixation, thus minimizing reoperation.

Does Extraction or Retention of the Wisdom Tooth at the Time of Surgery for Open Reduction and Internal Fixation of the Mandible Alter the Patient Outcome?

Whether to extract or retain wisdom teeth present in a fracture line is a controversial topic. This study reviewed the records of all patients who had mandibular wisdom teeth at the time of the injury, and had an open reduction and internal fixation procedure between January 2009 and January 2012. The cohort of patients who concomitantly had their wisdom tooth extracted at the time of fixation had a greater complication rate (24.3%) compared with patients who did not (14.9%). This suggests that if third molars in the line of a fracture have caries, are fractured, show signs of pericoronitis, are periodontally involved, or are interfering with the occlusion are extracted at the time of fixation, this will increase the incidence of complications.