Comminuted fractures of the basilar joint of the thumb: Combined treatment by external fixation, limited internal fixation, and bone grafting

Büchler, U; McCollam, Stephen M.; Oppikofer, Claude

doi:10.1016/0363-5023(91)90032-7

Cited by 49 publications

(17 citation statements)

References 25 publications

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“…Superficial pin site infection is recognised to be the most common complication of external fixation 11,13 and proved to be the most common complication in our series (3 out of 8 patients). In only one patient was early removal of the fixator required and this patient reported a worse functional outcome compared to the rest of the group.…”

Section: Complicationsmentioning

confidence: 54%

“…11,14,22 This system maintains thumb length and preserves the motion of the other joints. It also avoids devascularisation of the fracture, fibrosis of the collateral ligaments and tendon adhesion.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

mentioning

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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Section: Complicationsmentioning

confidence: 54%

Section: Discussionmentioning

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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“…16 In a series of 13 patients in this study, each fracture pattern demonstrated at least three articular fragments of the metacarpal base. External fixation was combined with interfragmentary screw fixation (one patient), K wires (six patients), a combination of screw and K wires (two patients) or no internal fixation (one patient).…”

Section: Non-operative Treatmentmentioning

confidence: 98%

Rolando and his fracture

Mahoney

Marsland

Garagnani

et al. 2014

Trauma

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The Rolando fracture is classically a Y pattern intra-articular fracture of the base of the thumb metacarpal. Due to the fracture's inherent instability and difficultly in achieving and maintaining accurate reduction, management remains challenging. This article explores Silvio Rolando's background, summarizes his classic paper from 1910 and reviews the current literature regarding optimal fixation techniques.

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“…The distal end allows traction via a banjo outrigger splint. For complex fractures, a combination technique of intermetacarpal external fi xation with bone grafting and adjunctive internal fi xation may be necessary [ 79 ]. If the fragments are of adequate size, an open reduction internal fi xation may be performed, with small lag screws incorporated through a T-or L-shaped plate [ 80 ].…”

Section: Intra-articular Base Fractures and Carpometacarpal Fracture-mentioning

confidence: 99%

Injury-Fractures-Carpo-Metacarpal Joint and Metacarpal

Hayton

2014

Disorders of the Hand

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Comminuted fractures of the basilar joint of the thumb: Combined treatment by external fixation, limited internal fixation, and bone grafting

Cited by 49 publications

References 25 publications

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

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

Rolando and his fracture

Injury-Fractures-Carpo-Metacarpal Joint and Metacarpal

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