Osteonecrosis of the Base of the Second Metacarpal: A Case Report

Irreducible Displacement of Comminuted Metacarpal Head Fracture

“…Avascular necrosis of MC bones is extremely rare [12], with a total number of less than 30 reported cases affecting almost exclusively the MC head [13]. We blame the degree of displacement responsible for the development of avascular necrosis in our patient, since the blood supply of the distal metacarpals is provided quite frequently only by small pericapsular arterioles [14].…”

Osteochondral Mosaicplasty as a Treatment Method for Bilateral Avascular Necrosis of the Long Finger Metacarpal: Case Report

“…Theoretically, repetitive minor trauma with excessive intra-articular pressure may result in occult microfractures with joint effusion, compressing the small arterioles to the distal epiphysis, and ultimately causing osteonecrosis. 8,13,14 Several studies do indeed report avascular necrosis in association with trauma or surgery for intra-articular fractures. [2][3][4] This may suggest that traumatic effusion is the most important etiologic factor.…”

“…Usually a trial of conservative therapy including rest, splinting, and nonsteroidal anti-inflammatory drugs is started. 2,3,8,9,11,14 Surgical decompression for symptomatic cases has been reported to bring pain relief and functional improvement. 8,14 Curettage and bone grafting should give better symptomatic results than decompression alone, as reported by several authors.…”

The idiopathic avascular osteonecrosis of the third metacarpal head (M. Mauclaire/Dieterich's disease)

“…The core decompression is the method of choice when smaller intra-osseous findings are present [6]. For larger intra-osseous focal findings, curettage and filling of the necrotic cavity with autologous cancellous bone grafts is recommended [3,21].…”

“…These observations have been found its confirmation in all subsequent publications. Usually, the symptoms occur in childhood and adolescence, followed by patients in the middle decades of life, elderly patients from the 5th decade of life are tend to be underrepresented, it also may be present in the 1st, 2nd, 4th and 5th metacarpal, and bilateral occurrence was observed as well [3][4][5][6][7][8][9][10][11].…”