Journal of orthopaedic surgery and research
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Fifth metacarpal neck fracture, also known as boxer's fracture, is the most common metacarpal fracture. Percutaneous Kirschner-wire (K-wire) pinning has been shown to produce favorable clinical results. However, the fixation power of K-wires is a major concern. Plate fixation is also a surgical option, but it has the disadvantages of tendon adhesion, requirement of secondary surgery for removal of the implant, and postoperative joint stiffness. A fixation method that causes little soft tissue damage and provides high biomechanical stability is required for patients with fifth metacarpal neck fracture for whom surgical intervention is indicated. The present study proposed fixation using K-wires and a cerclage wire to treat fifth metacarpal neck fracture. The fixation power of this new method was compared with that of K-wires alone and plates. ⋯ The fixation strength of two K-wires was significantly higher when reinforcement was provided using a figure-of-eight cerclage wire. The strength of the proposed approach is similar to that of a regular plate with five bicortical screws but weaker than that of a locking plate with the same amount of bicortical screws. Cerclage wire-integrated K-wires can be an alternative method that avoids the excessive soft tissue dissection required for plating in open reduction internal fixation for fifth metacarpal neck fracture.
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Comparative Study
Treatment of AC dislocation by reconstructing CC and AC ligaments with allogenic tendons compared with hook plates.
The purpose of this study was to compare outcomes between allograft reconstruction and hook plate fixation for acute dislocation of the acromioclavicular joint with a minimum 2-year follow-up. ⋯ The use of allogenic tendon for reconstruction of the coracoclavicular and acromioclavicular ligaments shows excellent outcomes in terms of the recovery of clinical function or radiographic outcomes for acute AC dislocation. Compared with the hook plate, the hardware did not need to be removed.
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Meta Analysis
Meta-analysis of the potential role of extracorporeal shockwave therapy in osteonecrosis of the femoral head.
We aimed to evaluate the role of extracorporeal shockwave therapy (ESWT) in improving osteonecrosis of the femoral head (ONFH). ⋯ For patients at an early stage, ESWT may be safe and effective for relief of pain and improvement of motor function.