Journal of hand surgery global online · 2025
Functional Outcomes of Miniplate/Screw Versus Suzuki Frame Fixation in Eaton Type III Middle Phalanx Base Fractures: A Case Series.
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Özdemir Ekrem, Altay Nasuhi, Topsakal Fatih Emre, Koçaslan Mehmet, Karabak Bilal, Demirel Esra
Аннотация
PURPOSE: To evaluate and compare the surgical and functional outcomes of dynamic external fixation using the Suzuki frame versus volar miniplate fixation for intra-articular Eaton type III fractures at the base of the middle phalanx.
METHODS: Thirty patients treated surgically between September 2022 and December 2023 were retrospectively analyzed. Group 1 (n = 15) underwent Suzuki frame application; group 2 (n = 15) received open reduction and internal fixation (ORIF) with a volar miniplate and screws. Operative time, complications, postoperative proximal interphalangeal joint range of motion, Visual Analog Scale, and Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores were compared. Statistical analysis included Student t tests, chi-square tests, effect size calculations, and minimal clinically important difference (MCID)-based clinical significance analysis, with P < .05 significance threshold.
RESULTS: Both groups achieved complete fracture union and a mean postoperative proximal interphalangeal range of motion of 90°. However, the Suzuki group demonstrated shorter operative times (27.1 vs 55.5 min), lower complication rates (6.6% vs 26.6%), reduced pain levels (Visual Analog Scale: 1 vs 2), and better functional recovery (QuickDASH: 2.3 vs 6.8). Disabilities of the Arm, Shoulder, and Hand scores showed statistically significant differences (Suzuki: 2.3 vs ORIF: 6.8, P = .040), but the 4.5-point difference fell below the established MCID threshold of 6.8 points. Visual Analog Scale pain scores also differed significantly (Suzuki: 1 vs ORIF: 2, P = .004), but the 1-point difference was below the MCID threshold of 1.6 points. Responder rate analysis showed similar proportions achieving clinically meaningful improvements (QuickDASH: 53.3% vs 46.7%, P = .742).
CONCLUSION: Despite achieving statistical significance, MCID-based analysis confirmed that the Suzuki frame and ORIF miniplate fixation techniques yield clinically equivalent outcomes in hand surgery. This finding underscores that treatment selection should not be driven by statistical superiority but rather by surgeon expertise, fracture-specific characteristics, patient-centered preferences, and health care resource considerations. Such an equivalence-based perspective provides a more meaningful framework for evidence-based, individualized, and cost-effective decision making in clinical practice.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.
METHODS: Thirty patients treated surgically between September 2022 and December 2023 were retrospectively analyzed. Group 1 (n = 15) underwent Suzuki frame application; group 2 (n = 15) received open reduction and internal fixation (ORIF) with a volar miniplate and screws. Operative time, complications, postoperative proximal interphalangeal joint range of motion, Visual Analog Scale, and Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores were compared. Statistical analysis included Student t tests, chi-square tests, effect size calculations, and minimal clinically important difference (MCID)-based clinical significance analysis, with P < .05 significance threshold.
RESULTS: Both groups achieved complete fracture union and a mean postoperative proximal interphalangeal range of motion of 90°. However, the Suzuki group demonstrated shorter operative times (27.1 vs 55.5 min), lower complication rates (6.6% vs 26.6%), reduced pain levels (Visual Analog Scale: 1 vs 2), and better functional recovery (QuickDASH: 2.3 vs 6.8). Disabilities of the Arm, Shoulder, and Hand scores showed statistically significant differences (Suzuki: 2.3 vs ORIF: 6.8, P = .040), but the 4.5-point difference fell below the established MCID threshold of 6.8 points. Visual Analog Scale pain scores also differed significantly (Suzuki: 1 vs ORIF: 2, P = .004), but the 1-point difference was below the MCID threshold of 1.6 points. Responder rate analysis showed similar proportions achieving clinically meaningful improvements (QuickDASH: 53.3% vs 46.7%, P = .742).
CONCLUSION: Despite achieving statistical significance, MCID-based analysis confirmed that the Suzuki frame and ORIF miniplate fixation techniques yield clinically equivalent outcomes in hand surgery. This finding underscores that treatment selection should not be driven by statistical superiority but rather by surgeon expertise, fracture-specific characteristics, patient-centered preferences, and health care resource considerations. Such an equivalence-based perspective provides a more meaningful framework for evidence-based, individualized, and cost-effective decision making in clinical practice.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.