Osteosynthesen mit resorbierbaren Hemizerklagen bei Metakarpalfrakturen*

Abstract

The use and results of biodegradable hemicerclages for metacarpal fracture fixation were reviewed retrospectively. A total of 92 metacarpal fractures in 78 patients were treated with polyglycolic or polydioxanon sutures. Study parameters included time for bony union, duration of immobilisation, total active range of motion, and complications. The hemicerclage achieved rigid fracture fixation and permitted early mobilisation exercises without jeopardizing bony union. Immobilization of metacarpals was performed for a median of 3.4 (1.5 to 6) weeks. There were no complications of wound healing. Adequate bony union was achieved after a median of 4.5 weeks (3.5 to 7 weeks). In one case, premature loading of the fracture led to displacement and delayed union. At the end of treatment (6.1 [4 to 7.5] weeks), total active range of motion was 98 (85 to 100)%. Ideal indications are oblique or torsion fractures of the metacarpals. In these cases, immobilisation up to wound healing is sufficient.

Intramedullary nailing for metacarpal 2–5 fractures

“…This required open reduction and a combination of cerclage wires and a wrist splint for 3 weeks [31]. The use of absorbable hemi-cerclage sutures needed 1.5-6 weeks immobilization and led to one redisplacement in 92 (combination of types) fractures [32].…”

Use of Bioabsorbable Osteofixation Devices in the Hand

“…user et al, 1999;Krein et al, 2000;Meyer-Clement et al, 1984). PGA or PDS sutures (2/0 USP) have been used to fix 92 metacarpal fractures in 78 patients.…”

“…One fracture redisplacement occurred, and the authors concluded that this method is suitable for the treatment of oblique and spiral fractures (Br . user et al, 1999;Krein et al, 2000). Rustemeier and Ganmann (1986) reported five cases of avulsion fracture of the extensor tendon, which were fixed with two 1.0 mm non-SR PDS pins and sutures.…”

“…Bioabsorbable threads have also been developed for the fixation of bones (Hattori et al, 2000;Morgan et al, 2001) and used in the management of metacarpal fractures (Br . user et al, 1999;Krein et al, 2000;Meyer-Clement et al, 1984). PGA or PDS sutures (2/0 USP) have been used to fix 92 metacarpal fractures in 78 patients.…”