Comparison of the radiological and functional results of a plaster splint and dynamic stabilization splint for Boxer's fractures: A prospective randomized controlled study

IF 1.5 4区 医学 Q3 ORTHOPEDICS
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Abstract

Purpose

This study compared the clinical and radiological results of fifth metacarpal neck fractures treated with a short-arm plaster splint (SAPS) versus a dynamic metacarpal stabilization splint (DMSS).

Materials and methods

The 119 patients were referred to our institute between 2018 and 2019 and treated with SAPS or DMSS after appropriate initial closed reduction. Follow-up examinations were conducted at days 10 and 20, and at 1, 2, and 3 months after treatment. Alignment of the fracture, range of motion (ROM), and complications were evaluated during each visit. Grip strength was evaluated using a dynamometer. Self-care, usual daily activities, pain/discomfort, and anxiety/depression were evaluated using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) and a VAS.

Results

Of the 119 patients, 103 completed all follow up examinations. In total, 51 patients were treated with SAPS and 52 with DMSS. Skin lesions were detected in five patients in the DMSS group, but none in the SAPS group (p = 0.008). The grip strength of patients in the DMSS group was statistically better at the 1-, 2-month and 3-month follow-up visits (p < 0.001). ROM of the interphalangeal and metacarpophalangeal joints were statistically better in the DMSS group at the 1-month visit (p < 0.001) but similar at the 3-month visit (p = 0.27). Wrist ROM was statistically higher in the DMSS group at the 3-month visit (p < 0.05). Self-care, usual daily activities, pain/discomfort, and anxiety/depression were statistically better in the DMSS group at all follow-up visits (p < 0.05), as determined by the EQ-5D-5L.

Conclusion

Dynamic stabilization of a stable boxer's fracture with DMSS is as effective as static stabilization with SAPS for maintaining the reduction and ensuring union. However, DMSS provides better early ROM, comfort, and muscle strength, as well as an earlier return to usual daily activities despite the occasional skin lesions happened.

比较石膏夹板和动态稳定夹板治疗拳击手骨折的放射学和功能效果:前瞻性随机对照研究
目的 本研究比较了采用短臂石膏夹板(SAPS)和动态掌骨稳定夹板(DMSS)治疗第五掌骨颈骨折的临床和放射学结果。材料和方法 2018年至2019年期间,119例患者转诊至我院,在适当的初次闭合复位后采用SAPS或DMSS治疗。在治疗后第10天、第20天、第1个月、第2个月和第3个月进行随访检查。每次就诊都会对骨折对位、活动范围(ROM)和并发症进行评估。使用测力计评估握力。此外,还使用EQ-5D-5L(EuroQol 5-Dimension 5-Level)和VAS对自我护理、日常活动、疼痛/不适以及焦虑/抑郁进行了评估。共有 51 名患者接受了 SAPS 治疗,52 名患者接受了 DMSS 治疗。DMSS 组有 5 名患者发现皮肤损伤,而 SAPS 组无皮肤损伤(P = 0.008)。在 1 个月、2 个月和 3 个月的随访中,DMSS 组患者的握力在统计学上更好(p < 0.001)。在1个月的随访中,DMSS组患者的指间关节和掌指关节的活动度在统计学上更佳(p <0.001),但在3个月的随访中情况相似(p = 0.27)。DMSS组的腕关节活动度在3个月访视时显著高于DMSS组(p <0.05)。根据EQ-5D-5L的测定,DMSS组在所有随访中的自理能力、日常活动、疼痛/不适以及焦虑/抑郁方面均优于DMSS组(p <0.05)。然而,DMSS能提供更好的早期活动度、舒适度和肌力,并能更早地恢复正常的日常活动,尽管偶尔会发生皮肤损伤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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