![]() ![]() Therefore, this study compared the effectiveness of two lag screws, regular bone plates, and locking bone plates for fixing horizontal oblique metacarpal shaft fractures. Moreover, no study has focused on fixation methods for horizontal oblique metacarpal shaft fractures. In addition, although many studies have investigated the fixation capacity of metacarpal transverse fractures, few have focused on oblique fractures. ![]() In this study, we proposed a new classification system for oblique metacarpal shaft fractures, conducted biochemical studies based on our classification, and identified the most favorable surgical fixation method for oblique metacarpal shaft fractures. To our knowledge, previous studies have not provided clear definitions for fracture classifications or suggestions for appropriate surgical treatments for oblique metacarpal shaft fractures. indicated that the use of lag screws can result in excellent fixation strength in long oblique metacarpal shaft fractures (defined as the fracture length being longer than the diameter of the metacarpal bone). In their biomechanical study, Adams et al. recommended lag screw fixation only for oblique phalangeal bone fractures and bone plate fixation for oblique metacarpal bone fractures. However, surgeons are often concerned lag screw fixation will be inadequately strong. Lag screw fixation is a minimally invasive surgical procedure. No consensus has yet been reached regarding whether lag screw or bone plate fixation is the most favorable surgical method. Therefore, most hand surgeons do not consider K-wire fixation as the primary treatment for oblique metacarpal fractures. In K-wire fixation, the fixation strength is insufficient to withstand the torsion load at the fracture site this can lead to the rotational malunion of the fracture and eventually to a scissoring deformity. Currently, the following surgical methods are the most commonly used in clinical practice to treat oblique metacarpal shaft fractures: (1) lag screw fixation, (2) bone plate fixation, and (3) K-wire fixation. ![]() ![]() Few studies have specifically focused on the clinical treatment of oblique metacarpal bone fractures. However, for complex fractures with comminution or unstable metacarpal fractures, such as oblique fractures, spiral fractures, or those involving the shortening of the metacarpal bone due to overlapping fracture ends, surgical intervention is required to prevent subsequent complications. Most metacarpal bone fractures can be treated conservatively. Metacarpal fractures are not uncommon and account for approximately 40% of all hand fractures. The fixation strength of two lag screw fixation did not significantly differ from that of regular and locking bone plate fixation, as indicated by the measurement of the ability to sustain force and stiffness. However, the mean stiffness value did not significantly differ among the three groups. The mean stiffness value of the two lag screw group (17.8 ± 2.6 N/mm) was lower than those of the regular plate group (20.2 ± 10.5 N/mm) and locking plate group (21.8 ± 3.8 N/mm). However, the mean failure force did not significantly differ among the three groups. The mean failure force of the two lag screw group (78.5 ± 6.6 N, mean + SD) was higher than those of the regular plate group (69.3 ± 17.6 N) and locking plate group (68.2 ± 14.2 N). The Kruskal–Wallis test was used to compare failure force and stiffness values among the three fixation methods. All the specimens were subjected to the cantilever bending test performed using a material testing machine to enable recording of the force–displacement data of the specimens before failure. Horizontal oblique metacarpal shaft fractures were created in 21 artificial metacarpal bones and fixed using one of the three methods: (1) two lag screws, (2) a regular plate, and (3) a locking plate. To investigate differences in the effectiveness of two lag screws, a regular bone plate, and locking bone plate fixation in treating horizontal oblique metacarpal shaft fractures. ![]()
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