Les fractures articulaires de la base du premier métacarpien

Brazier, Jean‐Michel; Moughabghab, M.; Migaud, Henri; Fontaine, C.; Elia, Antonella; Tillie, Bruno

doi:10.1016/s0753-9053(96)80014-7

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Al hacer una revisión bibliográfica del tema, no se han encontrado muchas publicacio-nes que traten específicamente, o por separado, sobre el tratamiento de las fracturas de Rolando 2,4,7,8 ; a menudo, en el análisis de resultados, las fracturas de Rolando aparecen mezcladas con fracturas de Bennett, ó incluso con fracturas extraarticulares del primer metacarpiano 3,5,6,9,10 .…”

Section: Discussionunclassified

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Osteosíntesis con placa en fracturas de Rolando

Sobrón

Celada

Bretones

et al. 2008

Rev Iberoam Cir Mano

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Objetivo: El objetivo del trabajo es valorar los resultados de las fracturas de Rolando tratadas mediante reducción y osteosíntesis. Material y Método: Se presentan 7 casos de fracturas de Rolando (3 conminutas y 4 de trazo en «Y») tratadas mediante reducción abierta y osteosíntesis con placa. Resultados: Los resultados tras una media de seguimiento de 3 años muestran una ausencia de artrosis radiológica, sin clínica dolorosa. Conclusión: Creemos que, a pesar de la dificultad técnica que representan, sobre todo los casos más conminutos, el tratamiento mediante cirugía abierta de estas lesiones ofrece al cirujano la posibilidad de un buen control de la reducción articular y una buena estabilidad primaria de la fractura para permitir una rehabilitación precoz.

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Section: Discussionunclassified

“…En el trabajo de Langhoff et al 6 sobre 17 fracturas de Rolando, 14 presentaban desplazamiento interfragmentario, y los autores optaron por realizar reducción abierta en 11 casos. Sin embargo, la osteosíntesis fue llevada a cabo con agujas de Kirschner, que no suelen proporcionar una buena estabilidad primaria.…”

Section: Discussionunclassified

Osteosíntesis con placa en fracturas de Rolando

Sobrón

Celada

Bretones

et al. 2008

Rev Iberoam Cir Mano

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“…We have evaluated our functional results on the base of four criteria used by most authors. 13,14 It includes two subjective criteria, namely, pain and grip strength, and two objective criteria, namely, thumb opposition and first web opening.…”

Section: Functional Assessmentmentioning

confidence: 99%

“…• Pain: It is rated in four levels according to Brazier: 13 Level 0: absence of pain with the contralateral hand, this force was classified into four groups according to Nonnenmacher: 15 Excellent: normal strength Good: discreet deficiency up to 20% in comparison with the contralateral hand Average: deficiency between 50%and 80%…”

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confidence: 99%

Comparative study of Iselin’s technique for the treatment of Bennett’s fracture with large and small fragments

et al. 2022

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Objective: The thumb is very exposed to trauma due to its position and function. Fractures of the base of the first metacarpal bone are very frequent in hand traumatology. Most Bennett’s fractures are treated surgically. However, the optimal surgical approach is controversial. The aim of this study is to compare the results of closed reduction and percutaneous pinning in the treatment of Bennett’s fracture of the base of firsthand metacarpal in fractures with both small and large fragments. Methods: We studied retrospectively the data of 40 patients treated for a Bennett’s fracture in the department of orthopaedic and traumatologic surgery between January 2016 and December 2018. The purpose of this study was to compare the functional (pain, grip strength, first web space opening and thumb opposition) and radiological (quality of reduction and arthritic changes) results of the Iselin’s technique for the treatment of Bennett’s fractures in two groups of patients with large and small bone fragments according to the size of articular surface detached with the antero-medial fragment (superior or inferior to 25%). Results: The average age of the patients was 34 (range = 19–66) years. Males were by far the most affected (90%). We noted 24 cases of large fragment fractures (60%) and 16 cases of small fragment fracture (40%). An excellent overall functional result was found in 68.8% of cases of small fragment fractures versus 50% of cases of large fragment fractures. Radiological results were roughly similar. Conclusion: All surgical techniques aim to restore the articular congruence to the best, maintain the opening of the first web space and obtain a stable and painless trapezo-metacarpal joint. The Iselin’s technique is simple, inexpensive and easy to perform even by inexperienced surgeons. It yields satisfactory results in most cases of Bennett’s fracture regardless of the size of the fragment.

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