Defining Nonunion for Metacarpal Fractures: A Systematic Review

Hayes, Daniel S.; Cush, Coleman; Koussaify, Jad El; Manzar, Shabih; Klena, Joel C.; Grandizio, Louis C.

doi:10.1016/j.jhsg.2023.04.014

Cited by 2 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The timing of an intervention post-hand fracture is imperative, as delays can have a significant impact on both patient functionality and productivity [30,31]. Up to 1.5% of metacarpal fractures result in non-union [20,32]. In fact, metacarpal non-union is more prevalent following open injuries associated with periosteal stripping and soft tissue trauma [33].…”

Section: Discussionmentioning

confidence: 99%

“…Hayes et al reported on the definition of metacarpal non-union across different investigations in the literature [20]. They concluded that the characterization of metacarpal non-union is highly variable and lacks a standardized definition.…”

Section: Discussionmentioning

confidence: 99%

“…A recent review on the definition of metacarpal non-unions concluded that the characterization of metacarpal non-union is highly variable and lacks a standardized definition [20]. Traditionally, surgical approaches have involved the use of percutaneous or internal fixation, bone grafts, or a combination of both in an effort to reach mechanical stability and facilitate bone healing [5,21].…”

Section: Introductionmentioning

confidence: 99%

“…Given the lack of reported metacarpal non-unions, their incidence within a broader population remains unknown. Hence, evidence-based insight into optimal management remains essential [20]. Nevertheless, the plethora of grafting techniques has made it difficult for the surgical community to reach a consensus gold standard for the treatment of non-union hand fractures [22].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Clinical, Radiologic, and Functional Outcomes following Bone Grafting for Metacarpal Non-Unions: A Systematic Review

El Sewify,

Abi-Rafeh,

Legler

et al. 2024

JCM

View full text Add to dashboard Cite

Objectives: Metacarpal non-unions are complex hand defects that can lead to severe hand impairment. Treatment may require the use of artificial or autologous bone grafts. This systematic review aims to describe the outcomes of bone grafting following metacarpal non-union in an attempt to establish an optimal therapeutic protocol for this complication. Methods: A systematic review was conducted in adherence with PRISMA guidelines. Data collection and analysis were performed in duplicate and confirmed by a third investigator. Our primary outcomes focused on radiological time to bone fusion and rates of non-union. Additionally, functional outcomes and complications were analyzed as means of central tendency. Results: Eighteen studies were included in the systematic review, accounting for a total of 47 patients. The average follow-up time was 12.4 months. Fourteen studies analyzed radiological outcomes, with atrophic non-union representing the most common type. The time to bone fusion, assessed radiologically, following bone graft was an average of 6.9 months (n = 14), with a 100% rate of union in 42 patients. Regarding patient-reported pain improvement, 76% of patients experienced pain relief. Moreover, all patients reported a complete subjective return to baseline hand function. Adverse events, limited to hematoma and seroma, were seen in three patients, representing a complication rate of 11.8% in the examined population. Conclusions: Metacarpal non-union can be treated successfully via vascularized and non-vascularized bone grafting. Based on the available evidence, bone grafts demonstrate favorable union rates, post-operative pain reduction, hand function recovery, earlier bone fusion times, and minimal complications in the context of metacarpal non-union management.

show abstract