Comparison study of three fixation methods for the treatment of the fifth metacarpal neck fractures

Objective To compare the clinical efficacy of closed reduction Kirschner wire transverse fixation, open reduction Kirschner wire cross fixation and open reduction plate screw fixation in the treatment of the fifth metacarpal neck fractures. Methods From March 2010 to January 2017, 83 patients with fresh closed fifth metacarpal neck fractures were treated by closed reduction Kirschner wire transverse fixation (34 cases as group A), open reduction Kirschner wire cross fixation (22 cases as group B) and open reduction plate screw fixation (27 cases as group C). According to the operation time, the number of C-arm fluoroscopy, complications, joint function recovery, grip strength and patient satisfaction, the efficacy of the three surgical methods was evaluated comprehensively. Results All the 83 patients were follow-up for 7 to 33 months with an average of 16.5 months. All the fractures achieved anatomical reduction and bone healing. At the last follow-up, there were no significant differences in grip strength, fracture healing time, complications and C-arm fluoroscopy frequency among the three groups (P>0.05). The operative time between group A and group B, group A and group C were significantly different (P 0.05). According to the upper extremity function evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association, the results were rated as excellent in 27 cases, good in 4 cases and fair in 3 cases with the excellent and good rate being 91.2% for group A; the results were rated as excellent in 15 cases, good in 5 cases and fair in 2 cases with the excellent and good rate being 90.9% for group B; the results were rated as excellent in 16 cases, good in 7 cases and fair in 4 cases with the excellent and good rate being 85.2% for group C. Conclusion The application of closed reduction Kirschner wire transverse fixation in the treatment of fresh closed fifth metacarpal neck fractures has the advantages of easy operation, short operation time, stable fixation, little joint and tendon irritation and allowing early functional exercise. It has satisfactory efficacy and is worthy of clinical promotion. Key words: Metacarpal bones; Fractures,bone; Comparative study; Kirschner wire; Plate