Weichteilschonende minimal-invasive Osteosynthesen bei Mittelhandfrakturen II–V

Abstract

In this retrospective study we analyzed metacarpal (MC) fractures that were treated with minimally invasive osteosynthesis during the period 2009-2010 and 65 patients (mean age 34.8 years, female/male 13/52) with 75 metacarpal fractures were enrolled. Fractures affected MC-2 (n=9), MC-3 (n=5), MC-4 (n=15) and MC-5 (n=46). Removal of implant was performed after 6-12 weeks in 44 patients. All fractures except one showed bony healing in x-ray. At 2-months follow-up 61 patients could be evaluated and at 27-months (15-37) follow-up 34 patients could be evaluated according to the DASH score. Median DASH score results were 16 points (SD 49, n = 61) after 2 months and median DASH score results were 5 points (SD 23, n = 34) after 27 months (15-37). Range of motion was limited in 6 patients after 8 weeks (range 6-12 weeks) with a deficit in flexion of finger to distal palmar crease of 1.0 cm (range 0.5-1.5 cm), 2 patients showed a deficit in finger extension of 10° in the metacarpophalangeal joint. One patient showed restricted finger extension of 15° in the proximal phalangeal joint after tendon rupture and tendon reconstruction. Complications were observed, such as circumscribed redness in two patients at the entry point of k-wires which was managed by early removal of the implant. Perforation of the k-wire occurred in one patient with subcapital and diaphyseal fracture and was managed by plate osteosynthesis. One diaphyseal transverse refracture healed after plate osteosynthesis, three circumscribed cases of paresthesia occurred, one at the entry point of the K-wires and two at the level of fracture.

Treatment of hand and finger fractures with the Stryker Hand Plating System

“…The primary indication for surgical treatment of metacarpal and phalanx fractures with a plate are dislocated, unstable fractures with rotational deformity and axial deviation [ 2 ]. Contrary to other authors, we do not consider the treatment of an open injury with plate osteosynthesis to be mandatory.…”

“…The vast majority of injuries to the fingers can be treated conservatively [ 1 ]. The indication for surgical treatment is always given when open or unstable fractures or intra-articular fractures or rotation defects are present [ 2 ]. Imaging is indispensable for confirming the diagnosis [ 3 ].…”

Treatment of Hand and Wrist Fractures with the Stryker Hand Plating System

“…The primary indication for surgical treatment of a metacarpal and phalanx fractures with a plate are dislocated, unstable fractures with rotational deformity and axial deviation 2 . Contrary to other authors, we do not consider the treatment of an open injury with plate osteosynthesis to be mandatory.…”

“…The vast majority of injuries to the ngers can be treated conservatively 1 . The indication for surgical treatment is always given when open or unstable fractures or intra-articular fractures or rotation defects are present 2 . Imaging is indispensable for con rming the diagnosis 3 .…”