Comparative analysis of the effects of AO mini-plate and Kirschner wire pinning in the metacarpal fractures: A retrospective study.

ABSTRACT: The aim of this study was to investigate the clinical effect of AO miniplate screw internal fixation and Kirschner wire (KW) in the treatment of metacarpal fractures.We retrospectively analyzed the clinical data of 590 metacarpal fracture patients admitted to our hospital from March 2016 to March 2019. Among them, 290 patients were treated with KWs; 300 were treated with AO microplate internal fixation. The clinical, radiological results, time of surgery, and complications were observed and compared between the 2 groups.The imaging characteristics and preoperative fracture types of the 2 groups were similar and comparable (P > .05). The operation time, length of hospital stay, and fracture healing time of AO group were shorter than those of KW group, and the differences were statistically significant (41.22 ±â€Š7.23 vs 25.64 ±â€Š6.29; 7.13 ±â€Š2.38 vs 5.26 ±â€Š1.71; 67.43 ±â€Š22.01 vs 52.57 ±â€Š17.46, P < .05). In addition, the incidence of postoperative complications in AO group was lower than that in KW group (8.3% vs 15.2%, P < .05). In terms of surgical knuckle extension, flexion, and total mobility (compared with the uninjured hand), patients in the AO plate group were significantly improved compared with patients in the KW group, and the difference was statistically significant (4 vs 10 degree; 19 vs 10 degree; 14 vs 29 degree, P < .05); The average degree of finger rotation deformity in AO plate group was significantly lower than that in KW group (1 vs 6 degree, P < .05). In terms of grip strength (compared with the healthy hand), the average grip strength of AO plate group was significantly higher than that of KW group (93% vs 83%, P < .05). Patients in the OA plate group had a lower Disabilities of the Arm, Shoulder and Hand score (P < .05).Compared with KW fixation, AO mini-plate and screw fixation for the metacarpal fracture has a better effect, which can effectively shorten the operation time and reduce the trauma to patients. It can provide patients with better stability and realize the early movement of the palm, promote fracture healing and joint function recovery; it can reduce the incidence of postoperative complications, which has certain safety. In addition, it can effectively reduce the risk of poor finger rotation.

Prevalencia de síntomas músculo-esqueléticos de la mano en estudiantes de odontología / Prevalence of Musculoskeletal Symptoms of the Hand Among Dental Students

Resumen Introducción: Los síntomas músculo-esqueléticos de las extremidades superiores son comunes entre los trabajadores dentales debido a la exposición a factores de riesgo, como movimientos repetitivos, esfuerzos intensos de manos, y malas posturas de muñecas. A medida que los estudiantes de odontología aprenden nuevas habilidades y procedimientos durante la escuela, experimentan un aumento gradual a estos factores de riesgo. El propósito de este estudio fue determinar la prevalencia de los síntomas musculo-esqueléticos (SME) de mano y muñeca entre los estudiantes de odontología de la Universidad de Iowa. Métodos: A 35 estudiantes de primer año y 39 estudiantes de cuarto año (N = 74) se les pidió que llenaran dos cuestionarios. Resultados: La prevalencia de los SME moderados/severos de la mano dominante como entumecimiento, hormigueo y dolor entre los estudiantes de primer año fue de 0, 6 y 20%, respectivamente, comparado con el 18,15 y 36% de los estudiantes de cuarto año. Conclusiones: Los SME de la mano dominante fueron más comunes entre los estudiantes de odontología de cuarto año, en comparación con los de primer año.

Abstract Introduction: Musculoskeletal symptoms of the upper extremities are common among dental workers due to exposure to risk factors including repetition, forceful exertions of the hand, and awkward wrist postures. As dental students learn new skills and procedures during dental school, they experience a gradually increasing exposure to these risk factors. The purpose of this study was to determine the prevalence of hand and wrist musculoskeletal symptoms (MSS) among dental students of the University of Iowa. Methods: Thirty-five first year students and thirty-nine fourth year students (N=74) were asked to complete two questionnaires. Results: The prevalence of moderate/severe MSS of the dominant hand such as numbness, tingling and soreness among first year students was 0, 6 and 20% respectively compared to 18, 15 and 36% of the fourth year students. Conclusions: In this relatively small sample, MSS of the dominant hand were more common among fourth year dental students when compared to first year students.

Prevention of Thumb Web Space Contracture With Multiplanar External Fixation.

Thumb web space contracture following hand trauma can be disabling with numerous reconstructive procedures existing to correct the resultant deformity. Following marked soft tissue injury to the hand we utilized the Stryker Hoffmann II Micro External Fixator System to link the first and second metacarpals by a multiplanar system using 1.6 or 2.0 mm self-drilling half-pins and 3 mm carbon fiber connecting rods. This facilitated placement of the thumb in maximal palmar abduction as well as allowed adjustment of thumb position throughout the postoperative period. This technique was performed on 5 patients. Two patients were treated with a first web space external fixator for table saw injuries to the radial aspect of the hand. An additional 2 patients were treated with a first web space external fixator following metacarpophalangeal joint capsular release in the setting of thermal burns. A fifth patient underwent second ray amputation, trapeziectomy and trapezoidectomy for squamous cell carcinoma with subsequent stabilization with the external fixator. The external fixator was left in place until soft tissues were healed (average 5.5 wk). The patients were allowed to mobilize their hand in as much as the external fixator allowed, and no device-associated complications were noted. Thumb web space was preserved with passive and supple thumb circumduction and web space abduction/adduction in all patients at an average follow-up of 5 months. The average Quick Dash Score was 35±5 and the average Modern Activity Subjective Survey of 2007 was 30±8.

[Pachydermodactyly]. / Pachydermodaktylie.

The differential diagnosis of swelling of the small finger joints is broad. We report on two young men presenting with progressive painless swelling of the proximal interphalangeal (PIP) joints where the physical examination was otherwise inconspicuous. Laboratory investigations including auto- antibodies were all normal, x-rays and magnetic resonance imaging (MRI) revealed no joint pathologies but only increased skin thickening. Skin biopsy demonstrated hyperkeratosis and acanthosis without tissue inflammation. We thus diagnosed pachydermodactyly in both cases. This rare disease predominantly affects young males, can affect one or both hands and is often associated with mechanical stress due to repetitive movements in patients with obsessive-compulsive disorders. Occupational exposure by monotonous actions (e.g. poultry processing) may also be a cause. A specific therapy is unnecessary in most cases but may include intralesional steroid administration or surgical resection. Cessation of mechanical stress can significantly improve pachydermodactyly.

Epiphysiodesis for bilateral irregular closure of the distal radial physis in a gymnast.

Wrist pain is a common complaint in gymnasts. Repetitive stress on the distal radial physis may lead to either gradual slipping of the epiphysis or growth disturbances. In some cases growth disturbances of the distal radial physis lead to triangulation of the distal radius and secondary ulnar overgrowth, and eventually a Madelung-like deformity. The present case report is the first to describe the outcome of epiphysiodesis of the distal radial and ulnar growth plates in a skeletally immature gymnast as a surgical treatment to prevent Madelung's deformity.