Quantitative 3-Dimensional CT Analyses of Intramedullary Headless Screw Fixation for Metacarpal Neck Fractures

Berg, P. T.; Mudgal, Chaitanya S.; Leibman, Matthew I.; Belsky, Mark R.; Ruchelsman, David E.

doi:10.1016/j.jhsa.2012.09.029

Cited by 75 publications

(60 citation statements)

References 28 publications

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“…This technique was further evaluated in a 3-dimensional computed tomographic (3D-CT) study, which examined the articular ramifications of retrograde headless bone screws for intramedullary metacarpal fixation. 17 It was found that the intraarticular screw occupied minimal metacarpal head surface area and subchondral head volume, thus representing a viable option for fracture fixation. 17 25 In this series, it is possible that mean time to radiographic union may appear delayed in some cases, as patients without complication did not routinely undergo radiographs between weeks 2 and 12.…”

Section: Discussionmentioning

confidence: 99%

“…17 It was found that the intraarticular screw occupied minimal metacarpal head surface area and subchondral head volume, thus representing a viable option for fracture fixation. 17 25 In this series, it is possible that mean time to radiographic union may appear delayed in some cases, as patients without complication did not routinely undergo radiographs between weeks 2 and 12. These data presented here further demonstrate that IMHS is a safe, effective, and durable solution for metacarpal neck and axially stable shaft fractures.…”

Section: Discussionmentioning

confidence: 99%

“…15 This technique has since been studied in both clinical and anatomical studies. 13,17,22 We hypothesized that IMHS fixation of metacarpal fractures allows for early mobilization without negatively affecting union rates. Here, we present the largest consecutive series of 91 metacarpal neck and shaft fractures treated with IMHS fixation with analysis of the clinical and radiographic outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Limited Open Intramedullary Headless Screw Fixation of Metacarpal Fractures in 91 Consecutive Patients

Eisenberg¹,

Clain

Feinberg-Zadek

et al. 2019

Hand (New York, N,Y.)

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Background: The objective of the study is to evaluate clinical and radiographic outcomes in patients treated with limited-open retrograde intramedullary headless screw (IMHS) fixation for metacarpal neck and shaft fractures. Methods: Retrospective review of 91 consecutive patients (79 men; 12 women), mean age 28 (range =15-69) years, treated with IMHS fixation for acute displaced metacarpal neck (N = 56) and shaft (N = 35) fractures at a single institution. Mean follow-up was 10 (range = 1-71, median = 3) months. Preoperative mean magnitude of metacarpal neck angulation was 48° (range = 0°-90°), and mean shaft angulation was 42° (range = 0°-70°). Active motion was initiated within 5 days postoperatively. Clinical outcomes were assessed with digital goniometry, grip strength, and return to full activity. The time to radiographic union and radiographic arthrosis was assessed. Results: All 91 patients achieved full functional arc of metacarpophalangeal (MCP) motion, and all achieved full active MCP extension or hyperextension. At mean followup of 10 months, postoperative mean MCP joint flexion-extension arc was 88° (range = 55°-110°). Grip strength was available for 52 patients and measured 104.1% of the contralateral hand (range = 58%-230%). Radiographic union data were available for 86 patients. Seventy-six percent (65/86) achieved radiographic union by the end of week 6 (range = 2-10 weeks). Early arthrosis was noted in 1 patient at the MCP. There were 3 cases of shaft refracture after recurrent blunt trauma, following prior evidence of full osseous union. Conclusions: The IMHS fixation is safe, reliable, and durable for metacarpal neck/subcapital, axially stable shaft fractures, and select delayed unions or malunions. It allows for early postoperative motion without affecting union rates and obviates immobilization. This technique offers distinct advantages over formal open reduction and percutaneous Kirschner wire techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Limited Open Intramedullary Headless Screw Fixation of Metacarpal Fractures in 91 Consecutive Patients

Eisenberg¹,

Clain

Feinberg-Zadek

et al. 2019

Hand (New York, N,Y.)

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“…Cumpliendo estos requisitos, la superficie articular de la cabeza del metacarpiano y el volumen subcondral ocupado por el tornillo compresivo son mínimos. 5 En un estudio cadavérico, Borbas y cols. establecieron que el daño de la superficie articular causado en el punto de entrada del tornillo en las articulaciones metacarpofalángica e interfalángica proximal es menor que el previamente establecido, cuantificado en 8,5% (tornillos de 3,0 mm) y 4,6% (tornillos de 2,2 mm) en promedio, respectivamente.…”

Section: S9unclassified

“…2 Se ha evaluado el compromiso de la superficie articular en el sitio de ingreso del tornillo mediante estudios cadavéricos y análisis de tomografías computarizadas 3D que avalan su uso. 4,5 El objetivo de este estudio es comunicar los resultados clínicos y radiográficos de pacientes con fracturas extrarticulares de falanges y metacarpianos de la mano, tratados mediante osteosíntesis mininvasiva con TECR.…”

Section: Introductionunclassified

Tratamiento de fracturas de falanges y metacarpianos con tornillos endomedulares compresivos

Layús

Pasetto

2020

Rev. Asoc. Arg. Ort. y Traumatol

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Objetivos: Evaluar los resultados clínicos y radiográficos de pacientes con fracturas extrarticulares de falanges y metacarpianos de la mano, tratados mediante osteosíntesis mininvasiva con tornillos endomedulares compresivos retrógrados. Materiales y Métodos: Estudio prospectivo que incluyó a pacientes >18 años con fracturas cerradas transversales u oblicuas cortas, extrarticulares, de falanges y metacarpianos tratadas entre noviembre de 2016 y junio de 2019. La serie estaba integrada por 47 pacientes, con 76 fracturas (28 de metacarpianos, 27 de falange proximal y 21 de falange media). Se evaluaron los resultados clínicos y funcionales con goniometría, registrando el rango de movilidad activa total. La evaluación radiográfica se realizó sobrela base de los criterios establecidos por Pun y cols. Todos los pacientes completaron el cuestionario QuickDASH en el examen final. Resultados: El tiempo promedio de seguimiento fue de 24.5 meses. El rango de movilidad activa total promedio fue de 238° para todas las fracturas, 252° para las de metacarpianos y 230° para las de falanges. Se observó la consolidación radiográfica de todas las fracturas. El tiempo promedio de retorno a la actividad habitual fue de 79 días. El resultado final del cuestionario QuickDASH fue 4,5. No hubo complicaciones ni cirugías secundarias. Conclusiones: La osteosíntesis mininvasiva con tornillos endomedulares compresivos retrógrados resultó una alternativa eficaz para el tratamiento de fracturas extrarticulares de falanges y metacarpianos. Palabras clave: Fractura; metacarpianos; falanges; tornillos endomedulares compresivos.Nivel de Evidencia: II

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Acute Fractures in Sport: Hand

Morse

Carlson

2021

Fractures in Sport

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Quantitative 3-Dimensional CT Analyses of Intramedullary Headless Screw Fixation for Metacarpal Neck Fractures

Cited by 75 publications

References 28 publications

Clinical Outcomes of Limited Open Intramedullary Headless Screw Fixation of Metacarpal Fractures in 91 Consecutive Patients

Clinical Outcomes of Limited Open Intramedullary Headless Screw Fixation of Metacarpal Fractures in 91 Consecutive Patients

Tratamiento de fracturas de falanges y metacarpianos con tornillos endomedulares compresivos

Acute Fractures in Sport: Hand

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