Arch Hand Microsurg 2018; 23(4): 230-238  
Comparative Analysis of Fracture Angulation between Parallel Pinning and Plate Fixation Techniques in the Management of 5th Metacarpal Fractures
Myungchul Lee, Hyojung Shin, Hyungon Choi, Jeenam Kim, Donghyeok Shin
Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Seoul, Korea
Correspondence to: Donghyeok Shin
Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea
TEL: +82-2-2030-7632, FAX: +82-2-2030-5249, E-mail: sdhplastic@kuh.ac.kr
Received: September 11, 2018; Revised: October 1, 2018; Accepted: October 3, 2018; Published online: December 1, 2018.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Metacarpal fractures are common injuries of the hand. They are treated using closed reduction (CR) or open reduction (OR) techniques. The management strategy depends on fracture site characteristic and fixation methods. In this study, we evaluated pre- and postoperative fracture angulation, when metacarpal fractures bad been treated using two different techniques: CR with parallel transverse pinning and OR with plate fixation.
Methods: Forty-six patients undergoing anatomic reduction to treat extra-articular metacarpal fractures were recruited. They were included in one of two therapeutic groups: Group 1, CR with parallel transverse pinning (n=21); Group 2, OR with plate fixation (n=25). Fracture angulation values have been measured on pre- and postoperative radiologic images. Values were compared between pre- and postoperative states, and between corresponding measurements of each group.
Results: All extra-articular metacarpal fractures were successfully treated without wound related complications or the limit of joint motion. Both groups demonstrated adequate reduction at immediate postoperative period (postoperative angulation of group 1, 20°±7°; group 2, 19°±5°). During the observation at follow-up period, Group 1 exhibited slight recurrence (follow-up angulation of group 1, 24°±10°). Nonetheless, Group 2 showed adequate reduction state in both immediate postoperative and long-term follow-up periods (follow-up angulation of group 2, 18°±6°).
Conclusion: Extra-articular metacarpal fractures were successfully restored without functional complications. CR with parallel transverse pinning method exhibited recurrence after pin removal, which necessitates cautious postoperative exercise and monitoring.
Keywords: Metacarpal bones, Fracture, Angulation, Closed fracture reduction, Open fracture reduction


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