Fractures of the base of the first metacarpal bone: results of surgical treatment

Niekerk, J.L.M. van; Ouwens, R.

doi:10.1016/0020-1383(89)90014-4

Cited by 54 publications

(58 citation statements)

References 7 publications

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“…In three patients, osteoarthritis Grade II [12] was present initially and did not worsen. For the seven other patients, arthritis Grade II (six patients) or III (one patient) developed after surgery.…”

Section: Long-term Follow-upmentioning

confidence: 89%

“…The results were classified according to the presence and extent of a gap or step. Arthritis was scored according to the arthritis classification of the CMC I joint by van Niekerk and Ouwens' [12] modification of the Eaton and Littler classification [13]. During the 4-month and last checkup, patients were examined with an image intensifier in order to more precisely evaluate the joint surfaces.…”

Section: Objective Assessmentmentioning

confidence: 99%

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7-year follow-up after open reduction and internal screw fixation in Bennett fractures

Leclère

Jenzer

Hüsler

et al. 2012

Arch Orthop Trauma Surg

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Background Bennett fractures are unstable, and, with inadequate treatment, lead to osteoarthritis, weakness and loss of function of the first carpometacarpal joint. This study focuses on long-term functional and radiological outcomes after open reduction and internal fixation. Methods Between June 1997 and December 2005, 24 patients with Bennett fractures were treated with open reduction and internal fixation with screws at our center. Radiological and functional assessments including range of motion of the thumb and pinch and grip strength were performed 4 months post-procedure and at the long-term follow-up, on average 83 months after surgery. Results Reduction of the Bennett fracture was maintained as it was at the time of the procedure in 96 % of the cases when fixation with two lag screws was performed. At the 4-month follow-up, mean pinch and grip strength reached 92 ± 3 and 89 ± 4 % of the contralateral side, respectively. Long-term follow-up demonstrated no correlation between the accuracy of the fracture reduction and the development of post-traumatic arthritis. Conclusion Good clinical results could be observed, if successful reduction of the fracture was achieved and maintained. However, there was no correlation between the accuracy of the fracture reduction considering a gap and step \2 mm and the development of arthritis.

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Section: Long-term Follow-upmentioning

confidence: 89%

Section: Objective Assessmentmentioning

confidence: 99%

7-year follow-up after open reduction and internal screw fixation in Bennett fractures

Leclère

Jenzer

Hüsler

et al. 2012

Arch Orthop Trauma Surg

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“…10,18 Open reduction may be feasible for the Rolando fracture when large fracture fragments permit good screw or K-wire purchase. 3,10,[18][19][20][21] There are concerns, however, that open reconstruction of the articular surface for a comminuted fracture is so difficult and prone to failure that it should not be undertaken routinely. 10,18 The comminuted Rolando fracture is not common so it is important that any potential treatment is effective and reliable yet simple enough for inexperienced surgeons to use, especially when access to a specialist hand surgeon is not available.…”

Section: Discussionmentioning

confidence: 99%

“…1 The Rolando fracture accounts for approximately 15% of fractures of the base of the first metacarpal bone 2 and is inherently unstable in the longitudinal axis (Fig 1). 3 Accurate reduction and fixation are essential in order to achieve a good outcome. [4][5][6][7] Malunion is associated with stiffness, pain, secondary arthrosis and pinch grip weakness.…”

mentioning

confidence: 99%

“…4,7,8 The optimal treatment for severe comminution is controversial. 3,9,10 External fixation is one option in this situation but there are few clinical series published. [11][12][13][14] We describe a simple, new technique for the treatment of the Rolando fracture with a static two-pin external fixator spanning the trapeziometacarpal joint and present the functional outcome in eight cases.…”

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confidence: 99%

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Static monolateral external fixation for the Rolando fracture: a simple solution for a complex fracture

Marsland

Sanghrajka

Goldie

2012

annals

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INTRODUCTION Rolando fractures are often difficult to manage because of their inherent instability. We describe a simple technique for the treatment of this fracture using the principle of ligamentotaxis, with a static, two-pin external fixator spanning the trapeziometacarpal joint, and present the results of a single-surgeon case series. METHODS Eight consecutive patients (mean age: 32.8 years) with Rolando fractures were treated using a Hoffmann II ® Micro small bone external fixator using blunt ended 2.0mm half pins, inserted into the trapezium and diaphysis of the first metacarpal. Functional outcome was assessed with the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score at a mean time of 2.7 years following the fracture (range: 4 months -6.0 years). The mean time to frame removal was 28 days. RESULTS There were three cases of superficial pin site infection. Follow-up x-rays at four months did not demonstrate significant joint incongruity or malunion in any case. The mean QuickDASH score was 7.95 and all patients returned to their previous levels of activity. CONCLUSIONS Although external fixation risks pin site infection, the results of this study support the use of spanning trapeziometacarpal external fixation for Rolando fractures as it reliably gives excellent functional outcomes.

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Base of Thumb Fractures

Pasqualini,

Holc,

Boretto

2024

Orthopaedics and Trauma

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Fractures of the base of the first metacarpal bone: results of surgical treatment

Cited by 54 publications

References 7 publications

7-year follow-up after open reduction and internal screw fixation in Bennett fractures

7-year follow-up after open reduction and internal screw fixation in Bennett fractures

Static monolateral external fixation for the Rolando fracture: a simple solution for a complex fracture

Base of Thumb Fractures

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