Comparison of the fixation ability of headless compression screws and locking plate for metacarpal shaft transverse fracture

Chiu, Yung-Cheng; Hsu, Chiann‐Yi; Ho, Tsung-Yu; Ting, Yen-Nien; Wei, Bor-Han; Tsai, Ming-Tzu; Hsu, Jui‐Ting

doi:10.1097/md.0000000000027375

Cited by 5 publications

(1 citation statement)

References 37 publications

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“…Therefore, the repair and healing of fractures have always been a debate for orthopedic surgeons. Fractures are often treated using a method called reduction and compression fixation [3], but this treatment approach is known to be timeconsuming and highly restrictive for patients in terms of daily activity. As a result, it causes significant physical and psychological stress for patients.…”

Section: Introductionmentioning

confidence: 99%

Effect of Mongolian medicine alcohol spray therapy on fracture healing in rabbits

Wu,

2024

Trop. J. Pharm Res

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Purpose: To evaluate the healing effect and mechanism of Mongolian medicine alcohol spray therapy on fracture healing process in rabbits. Methods: Thirty New Zealand white rabbits were randomly divided into normal, fracture, and treatment groups, with 10 rabbits in each group. Fracture and treatment groups underwent bone-fracture modeling, with the latter receiving daily alcohol spraying and stroking for six weeks. Serum calcium and phosphorus were measured using an automatic biochemical analyzer. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of BMP-2, ALP, and TGF-β. Biomechanical testing was performed to assess callus properties, and real-time polymerase chain reaction (PCR) and western blot were performed to assess BMP-2, Runx2, and p-Smad1/5 expressions in callus. Results: There were low serum calcium, phosphorus, BMP-2, ALP, and TGF-β levels in fracture and treatment groups, compared to normal group. Similarly, treatment group showed significantly increased levels of serum calcium, phosphorus, bone morphogenetic protein 2 (BMP-2), alkaline phosphatase (ALP), and transforming growth factor-β (TGF-β) (p < 0.05) compared to fracture group. Biomechanical testing revealed that maximum load, stiffness, and deflection of callus in the fracture and treatment groups were significantly lower compared to normal group (p < 0.05). expressions of BMP-2, Runx2, and p-Smad1/5 mRNA in the callus significantly decreased in both fracture and treatment groups compared to normal group (p < 0.05). However, treatment group showed significantly increased expression levels compared to fracture group (p < 0.05). Conclusion: Mongolian medicine alcohol spray therapy promotes fracture healing in rabbits and increases maximum load of the callus, possibly through upregulation of the BMP-2 signaling pathway. Further research is necessary to confirm the exact mechanism by which alcohol spray therapy regulates BMP-2 signaling pathway.

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Section: Introductionmentioning

confidence: 99%

Effect of Mongolian medicine alcohol spray therapy on fracture healing in rabbits

Wu,

2024

Trop. J. Pharm Res

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Percutaneous transverse pinning for metacarpal fractures: a clinical trial

Pintore,

Astone,

Vecchio

et al. 2024

Arch Orthop Trauma Surg

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Introduction Metacarpal fractures account for 25%-50% of all hand fractures and may negatively impact hand function and ability to work. Percutaneous transverse pinning of non-articular metacarpal fractures allows mobilisation immediately after the procedure. Methods Between March 2017 and February 2022, 56 patients undergoing percutaneous transverse pinning for unstable metacarpal fractures were prospectively recruited. We investigated surgical outcomes in terms of Patient-rated Wrist/Hand Evaluation (PRWHE) and pre-and post-operative radiographic evaluation. The Student t-test was used to compare the means of PRWHE values after surgery. Statistical significance was set at p < 0.05. Results The mean age was 40.21 ± 17.9 years (range of 16 to 86 years). The average operating time was 27.96 min. The mean follow-up period was 14.3 ± 6.4 months (from 2 to 41 months). The mean PRWHE score was 6.5 ± 1.8. None of the patients had clinically observable rotational deformities, and the functional outcomes were satisfactory. Conclusion Percutaneous transverse pinning for non-articular metacarpal fractures restores excellent function, and imaging results are satisfactory. Further high-quality clinical trials are required to validate these results on a larger scale. Level of evidence II, prospective cohort study.

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Comparison of the fixation ability between lag screw and bone plate for oblique metacarpal shaft fracture

Chiu

Hsu

et al. 2022

J Orthop Surg Res

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Background For oblique metacarpal shaft fracture, if anatomical reduction is achieved through conservative cast immobilization rather than stable fixation, bone malrotation can easily occur, resulting in severe loss in hand prehensile function. However, whether bone plate fixation or only lag screw fixation is more preferable remains unclear. Few studies have evaluated whether screw fixation can provide biomechanical fixation strength similar to bone plate fixation. Objective We assessed the difference in fixation strength between fixtation with two lag screws and bone plate for oblique metacarpal shaft fractures. Materials and methods We created oblique metacarpal shaft fractures on 21 artificial bones and fixated them using (1) double lag screw (2LS group), (2) regular plate (RP group), or (3) locked plate (LP group). To obtain the force–displacement data, a cantilever bending test was conducted for each specimen through a material testing machine. One-way analysis of variance and a Tukey test were conducted to compare the maximum fracture force and stiffness of the three fixation methods. Results The maximum fracture force of the 2LS group (mean + SD: 153.6 ± 26.5 N) was significantly lower than that of the RP (211.6 ± 18.5 N) and LP (227.5 ± 10.0 N) groups (p < 0.001). However, no significant differences were discovered between the RP and LP groups. The coefficient of variation for the maximum fracture force of the 2LS group (17.3%) was more than twice as high as that of the RP (8.7%) and LP (4.4%) groups. In addition, the stiffness of the three fixation methods was similar. Conclusion Compared with bone plate fixation, double lag screw fixation yielded slightly lower maximum bearable fracture force but similar stiffness. Therefore, this technique could be used for treating oblique metacarpal shaft fractures. However, using double lag screw fixation alone is technically demanding and requires considerable surgical experiences to produce consistent results.

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Comparison of the fixation ability of headless compression screws and locking plate for metacarpal shaft transverse fracture

Cited by 5 publications

References 37 publications

Effect of Mongolian medicine alcohol spray therapy on fracture healing in rabbits

Effect of Mongolian medicine alcohol spray therapy on fracture healing in rabbits

Percutaneous transverse pinning for metacarpal fractures: a clinical trial

Comparison of the fixation ability between lag screw and bone plate for oblique metacarpal shaft fracture

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