Locking plate versus retrograde intramedullary headless compression screw for unstable extra-articular metacarpal base fractures of the thumb.

Injury Pub Date : 2023-12-01 Epub Date: 2024-01-13 DOI:10.1016/j.injury.2023.110891

Sergi Barrera-Ochoa, Maximiliano Ibañez, Soldado Francisco, Rita Sapage, Sergi Alabau-Rodríguez, Xavier Mir-Bullo

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Abstract

The purpose was to compare clinical and radiological outcomes between two fixation techniques used to treat extra-articular fractures involving the base of the thumb metacarpal: retrograde intramedullary cannulated headless screw (RICHS) and locking plate (LP). Fifty-one patients who underwent RICHS (n = 22) or LP fixation (n = 29) from January 2010 through 2020 were included in this retrospective case-control study with mean follow-up 39 months. No inter-group differences were observed comparing mean time to radiological union, grip strength, range of motion, pain severity or QuickDASH scores. Mean surgery time was shorter with RICHS (18.9 min) than with LP fixation (44.4 min). Mean time to return to work or routine activities was less in RICHS than LP (22 vs. 32 days), as was the percentage of patients requiring hardware removal (0% vs. 44.8%). We conclude that RICHS fixation requires less operating time and yields faster post-operative return to full function and fewer secondary procedures.

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锁定钢板与逆行无头髓内加压螺钉治疗不稳定的拇指关节外掌基底骨折。

目的是比较两种用于治疗涉及拇指掌骨基底部的关节外骨折的固定技术：逆行髓内无头螺钉（RICHS）和锁定钢板（LP）的临床和放射学结果。这项回顾性病例对照研究纳入了从 2010 年 1 月到 2020 年接受 RICHS（22 例）或 LP 固定（29 例）的 51 例患者，平均随访时间为 39 个月。比较平均放射学结合时间、握力、活动范围、疼痛严重程度或 QuickDASH 评分，未观察到组间差异。RICHS的平均手术时间（18.9分钟）短于LP固定术（44.4分钟）。与 LP 相比，RICHS 恢复工作或日常活动的平均时间更短（22 天 vs. 32 天），需要移除硬件的患者比例也更低（0% vs. 44.8%）。我们的结论是，RICHS固定所需的手术时间更短，术后恢复功能更快，二次手术更少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Injury

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