Clinical Comparison Of Closed Reduction And Kirschner Wire Fixation Combined With Dynamic Treatment And Traditional Open Reduction And Plate Fixation For Proximal Phalanx Fracture

Objective:To compare the clinical outcomes of closed reduction and Kirschner wire fixation combined with dynamic treatment and traditional open reduction and reduction plate fixation for proximal phalanx fractures.Methods:81 patients with proximal phalangeal fractures were treated from June 2011 to August 2017.Among them,42 patients with closed reduction and Kirschner wire fixation combined with dynamic treatment(group A);traditional open reduction and internal fixation 39 patients(group B)were treated.The demographic data,injury index,cause of injury,proportion of fracture site and fracture line morphology,were similar.Therefore,the treatment results of this study have Comparability.The standard positive lateral radiographs of the patients were taken before,during and after the follow-up.The operation time,recovery time,total finger joint activity,Quick-DASH and VAS scores and the grip strength of the two groups were followed up,and the two groups were statistically compared.Results:All patients were followed up.The follow-up time of group A was 6-15 months,with an average of 11.5 months.The follow-up time of group B was 7-14 months,with an average of 12.2 months.There was no significant difference in follow-up time between the two groups.The operation time of group A were significantly lower than those of group B.The percentage of total activity of finger joints in TAM,recovery time,and grip strength and pinching was significantly higher than that in group B(P<0.05).There were no significant differences in Quick-DASH and VAS(P>0.05).Postoperative complications were 9.5%(4/42)in group A while were 12.8%(5/39)in group B.Conclusion:The clinical result of closed reduction and percutaneous Kirschner wire fixation combined with dynamic treatment of proximal phalanx fracture is better than traditional open reduction and plate fixation for proximal phalanx fracture,which can restore the finger function while the fracture is healing,and there are fewer complications.This program is safe and effective in the treatment of proximal phalanx fractures.