Resumo

FERRANDO, Ángel et al. Osteosíntesis en fracturas oblicuas o espiroideas largas de metacarpianos: comparación entre tratamiento con tornillos interfragmentarios solos y placa con tornillos. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2021, vol.86, n.5, pp.621-628. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2021.86.5.1345.

Objective: To compare open reduction and internal fixation with interfragmentary screws and with plates and screws for the treatment of long oblique or spiral metacarpal fractures. Materials and Methods: A comparative retrospective study was carried out between 2 groups of patients treated surgically. In the first group, 24 patients were treated with interfragmentary screws and in the second group, 17 patients were treated with plate and screw osteosynthesis. A dorsal longitudinal approach was used. Postoperatively, immobilization was performed using a plaster splint; both groups followed rehabilitation with same occupational therapist team. After a minimum follow-up of 12 months, they were evaluated with the DASH score, total active motion (TAM), pulp-to-palm distance, and comparative contralateral dynamometry. A p value < 0.05 was considered significant. Results: The average follow-up was 24.5 months (range 12-43 months). There were no statistically significant differences in DASH, TAM, pulp-to-palm distance, and strength. The group treated with plate and screw fixation returned to work earlier, although there were two cases of implant removal, in addition to tendon adherence (tenolysis) in one of them. Conclusions: The treatment of patients with long oblique or spiral metacarpal fractures with interfragmentary screws or plates and screws showed similar outcomes; the treatment with plate and screws allowed an earlier return to work but had a greater number of complications.

Palavras-chave : Fracture; metacarpal; osteosynthesis; plate; screws alone.

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