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Randomized Clinical Trial for Surgical Treatment - Proximal Phalanx Fractures - MIPO versus lateral plate
Marcio A. Aita, MD; Gasparotti Eduardo, Resident; Alvaro Baik Cho, PROF, DR; Rafael Saleme, resident; Faculdade de Medicina do ABC
ABC Foundation, Sao Bernardo do Campo, Brazil

Objectives: To compare the clinical and functional results of patients with diagnosis of unstable fractures of the proximal phalanx underwent surgical treatment for the minimally invasive technique using screw Acutrak ® - Acumed ® versus conventional technique with the use of 1.5mm and 2.0mm plate positioned laterally in the falange.Material and methods: This study included 25 patients, 28 phalanges, all reducible and diagnosis of unstable fractures of the proximal phalanx of the fingers of the hand, and were subdivided into two groups, matched by randomization. Each group has 14 phalanges operated, group A patients treated with the board "side", and group B patients treated with screw Acutrak ®. All patients were rehabilitated by the industry of hand therapy institution, always using the same protocol. Patients were evaluated during the third week, sixth week and sixth month. Were calculated: the goniometric measurement, in degrees, range of motion, the DASH, the subjective assessment of pain by visual analog scale and the evaluation of radiographic fracture.
Results: Patients in group B have the best clinical and functional results. The complication rate and 3.5%, one patient in group A had postoperative infection with exposure of the implant which was removed and is still going to outpatient treatment adm limitation of this finger. All patients kept the reduction of the fracture after the sixth month of surgery. Patients in group B returned to work before the patients in group A. Conclusion: The minimally invasive technique for treating these fractures is a method effective, safe and fast, with a low index of complications.
Both implants maintain the reduction of the fracture until the sixth month of surgery
The best clinical and functional results and earlier return to work are found in patients of group B


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