Closed reduction intermetacarpal Kirschner wire fixation in the treatment of unstable fractures of the base of the first metacarpal

Greeven, Alexander P A; Alta, T.D.W.; Scholtens, R.E.M.; Heer, Pieter de; Linden, Frits M. Van der

doi:10.1016/j.injury.2011.10.038

Cited by 40 publications

(48 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The grip and pinch strength were compared with the normal side. For radiological assessment van Niekerk and Ouwens modification of the Eaton and Littler classification of posttraumatic osteoarthritis 14,15 was used: Stage I: no clear arthrotic changes, stage II: osteophytes smaller than 2 mm, stage III: osteophytes larger than 2 mm or joint narrowing, and stage IV: joint space more or less disappeared.…”

Section: Operative Techniquementioning

confidence: 99%

Treatment of Rolando Fractures by Open Reduction and Internal Fixation using Mini T-Plate and Screws

et al. 2016

View full text Add to dashboard Cite

Introduction?Rolando fractures being intra-articular fractures of the most mobile joint of the thumb, assume significance because any residual incongruity of the articular surface may result in loss of motion as well as secondary osteoarthritis and hence serious disability. This fracture continues to pose difficulties to the treating surgeons and although several treatment options have been described for these fractures, there are no definite guidelines. Methods?The present study describes the results of open reduction and internal fixation of nine Rolando fractures with large and single fragments, using mini T-plate and screws. Results?At 3-year follow-up all the fractures had united, functional results were excellent or good in most cases, and all the patients had returned to previous activities. Significant complications such as deep infection and loss of reduction were not encountered in any patient. Conclusion?Open reduction and internal fixation with mini T-plates in properly selected cases of Rolando fracture with large and single palmar and dorsal articular fragments offers several advantages such as allowing direct visualization of the joint, removal of interposed soft tissues, and exact anatomical restoration of the articular surface. The fixation in most cases is rigid enough to allow early mobilization without loss of reduction. Thus, complications such as stiffness as well as future arthrosis may be minimized. However, the technique is demanding and needs high degree of precision. The possibility of implant removal should be discussed beforehand with the patient.

show abstract

Section: Operative Techniquementioning

confidence: 99%

Treatment of Rolando Fractures by Open Reduction and Internal Fixation using Mini T-Plate and Screws

et al. 2016

View full text Add to dashboard Cite

show abstract

“…There are various reported means of fixation: pins (Bennani et al, 2012;Culp and Johnson, 2010;Greeven et al, 2012;Lutz et al, 2003); screws (Leclère et al, 2012;Meyer et al, 2003;Strömberg, 1977;Tourne et al, 1988); or plates (Pavic and Malović, 2013;Uludag et al, 2013).…”

Section: Treatmentmentioning

confidence: 99%

Fractures and dislocation of the base of the thumb metacarpal

Liverneaux

Ichihara

Hendriks

et al. 2014

J Hand Surg Eur Vol

View full text Add to dashboard Cite

Acute traumatic lesions of the base of the first metacarpal are frequent and their consequences can affect the opposition of the thumb. They usually occur after trauma in compression along the axis of the thumb in flexion. Restoring the anatomy and biomechanics of the trapeziometacarpal joint is essential when treating these injuries, hence why surgical treatment is usually indicated. We distinguish trapeziometacarpal dislocations, small-fragment and large-fragment Bennett's fractures, articular three-fragment Rolando and comminutive fractures and extra-articular fractures of the base of the first metacarpal. All carry the risk of narrowing of the first web. Recent studies have described poor results with conservative treatment. Surgical techniques are varied: percutaneous surgery, open surgery and arthroscopic surgery. The techniques of osteosynthesis are various: locking plates, and direct or indirect screw fixation or pinning. The prognosis depends on the quality of the restoration of the mobility of the trapeziometacarpal joint.

show abstract

“…3,4 Most fractures of the base of the first metacarpal are unstable and require surgery. 8 The percutaneous techniques described 50 years ago, [9][10][11] are the most widely used since they minimize adhesions of the extensor apparatus. 8 The percutaneous techniques described 50 years ago, [9][10][11] are the most widely used since they minimize adhesions of the extensor apparatus.…”

Section: Historical Perspectivementioning

confidence: 99%

Percutaneous Fixation of First Metacarpal Base Fractures Using Locked K-Wires

Adi

Miyamoto

Taleb

et al. 2014

Techniques in Hand &Amp; Upper Extremity Surgery

View full text Add to dashboard Cite

The treatment of choice for first metacarpal base fractures is surgical. Open fixation is stable but causes tendinous adhesions. Percutaneous fixation is minimally invasive but is often followed by secondary displacement. Herein, we describe an alternative approach that combines advantages of both techniques through increasing stability of the Iselin technique by externally connecting the K-wires. Our series included 13 men of mean age 28 years. There were 13 fractures, 6 of which were extra-articular; there were 7 Bennett fractures, 5 of which had a large fracture fragment. After reduction, two 18 mm K-wires were driven medially crossing the 3 cortices of the first and second metacarpals. After bending them at 90-degree angles, the K-wires were connected externally in a construction allowing adaptation of the gap between the K-wires. Gentle immediate mobilization was allowed and the K-wires were removed 6 weeks later in clinic. At 16-month follow-up, mean pain score was 0.2/10 and Quick DASH was 2.9/100. Pinch grip was 81.8% of the contralateral side and grip strength 91.2%. The first web space opening was 79.1%. There was 1 secondary displacement with a good final result and 2 malunions. No arthritis was noted, but the follow-up was short. Our results show that the Iselin technique using locked K-wires is minimally invasive, stable, allows immediate mobilization, and K-wire removal in the office. Its indications may be extended to all fractures of the base of the first metacarpal whether articular or extra-articular.

show abstract

Closed reduction intermetacarpal Kirschner wire fixation in the treatment of unstable fractures of the base of the first metacarpal

Cited by 40 publications

References 20 publications

Treatment of Rolando Fractures by Open Reduction and Internal Fixation using Mini T-Plate and Screws

Treatment of Rolando Fractures by Open Reduction and Internal Fixation using Mini T-Plate and Screws

Fractures and dislocation of the base of the thumb metacarpal

Percutaneous Fixation of First Metacarpal Base Fractures Using Locked K-Wires

Contact Info

Product

Resources

About