Method of surgical treatment of metaepiphyseal fractures of the metacarpal bones

Fractures of the metacarpal bones make up more than 30% of all traumatic lesions of the bone system and in its frequency significantly exceed the damage of other localizations in clinical practice[1]. In connection with the previously stated a new method of treatment has been applied for the healing of patients with comminuted metaepiphyseal metacarpal fracture - intramedullary osteosynthesis with conjugated three-beam spoke. The purposes of this study are to test and apply a new treatment method in private practice for metaepiphyseal fracture of the metacarpal bone of the hand - osteosynthesis with conjugated three-beam simulated spoke. Material and methods. The method of surgical treatment of metaepiphyseal fractures of the metacarpal bones including reposition and intramedullary osteosynthesis differs in that a spoke was used for osteosynthesis, modeled by its double bending along its length with the formation of three parts so that the length of the middle part corresponds to the length of the medullary canal of the injured metacarpal bone. Our developed method, protected by Russian Federation patent for the invention: "Method of surgical treatment of metaepiphyseal fracture of the metacarpal bone" № RU 2676463 C1. Fixations of metacarpal fractures are stable due to the fact that the spoke which is in the base of the metacarpal bone in the medullary canal does not pass into the main phalanx of the finger and, thus, the spoke provides the full function of the hand already on the second day after the operation. Statistical analysis of the results was carried out using the SPSS 20.0 program with parametric statistics methods. Results. For the period from 2017 to 2020 inclusive 70 osteosyntheses were performed with a conjugated simulated spoke for metaepiphyseal fractures of the metacarpal bones in the clinic of the specialized department of the hand on the basis of the City Clinical Hospital No. 4. Of these, there were 52 men (74.3%), women - 18 (25.7%), the average age of the victims was 25.5 ± 4.9 years. The groups are comparable in terms of the initial severity of the condition and the main demographic indicators. The results of the treatment were followed in all operated patients after 2 months, long-term results - after six months. In all cases the result was recognized as different with full restoration of function, with no complaints, without restriction of labor activity. A good result - with the restoration of function after 2 months. A satisfactory result - with the restriction of the function after six months. The analysis of the intensity of pain at rest discovered that on the 1st day after surgical treatment the pain intensity was 6.4±2.1 points (table). On the 5th day the pain has been decreasing by 1.5 points, while the differences didn’t reach a significant character. In the study on the 7th day the pain decreased by 18% (p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }