Surgical Outcomes of Percutaneous Pinning and Open Locking Plating in Patients With Intra-Articular Fractures of the Base of the Fifth Metacarpal

IF 2.1 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2024-12-01 DOI:10.1016/j.jhsa.2023.03.024

Jung Il Lee MD, PhD , Jong Woong Park MD, PhD , Yong Jin You MD , Young Hoon Jo MD, PhD , Ki-Chul Park MD, PhD

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引用次数: 0

Abstract

Purpose

The purpose of the study was to demonstrate the results of surgical treatment, including percutaneous K-wire fixation after closed reduction (CRKF) or locking plate fixation after open reduction (ORPF), in patients with intra-articular fractures of the base of the fifth metacarpal.

Methods

We retrospectively reviewed data of 29 patients who received surgical treatment for closed, intra-articular fractures of the base of the fifth metacarpal and were followed up for at least 1 year after surgery. Sixteen of the 29 patients underwent CRKF, whereas 13 patients underwent ORPF. Attempts were made to address intra-articular step-off with closed reduction in all the patients; however, if inadequate, ORPF was performed. Clinical outcomes were evaluated using Disabilities of the Arm, Shoulder, and Hand scores, visual analog scale pain scores, the total active motion (TAM) of the little finger, and grip strength. Osseous union and posttraumatic arthritis of the fifth carpometacarpal joint were also evaluated.

Results

K-wire fixation after closed reduction was performed for 13 simple fractures and 3 comminuted fractures; ORPF was performed for 6 simple fractures and 7 comminuted fractures. All the patients had satisfactory subjective outcomes with over 90% grip strength compared with that on the contralateral side and nearly full TAM. All the patients in both the groups achieved osseous union. There were five cases of grade 1 posttraumatic arthritis after CRKF and seven cases of grade 1 posttraumatic arthritis after ORPF.

Conclusions

Surgical treatment provided satisfactory results in patients with intra-articular fractures of the base of the fifth metacarpal treated with either CRKF or ORPF. Our data showed that the patients who underwent CPKF had good results, and those who underwent ORPF after attempt failure of close reduction also had good results. Our experience suggests that ORPF can be a backup plan when CRKF cannot be accomplished in a satisfactory way.

Type of study/level of evidence

Therapeutic IV.

查看原文本刊更多论文

经皮钉钉和开放锁定钢板治疗第五掌骨底关节内骨折的手术效果。

目的：本研究的目的是展示手术治疗的结果，包括经皮闭合复位后k针固定（CRKF）或切开复位后锁定钢板固定（ORPF），治疗第五掌骨底关节内骨折患者。方法：回顾性分析29例第5掌骨基部闭合性关节内骨折患者的手术治疗资料，术后随访至少1年。29例患者中有16例接受了CRKF，而13例接受了ORPF。所有患者均尝试通过闭合复位来解决关节内步脱问题；但是，如果不充分，则进行ORPF。临床结果采用手臂、肩部和手部残疾评分、视觉模拟疼痛评分、小指总主动运动（TAM）和握力进行评估。骨愈合和第五腕关节创伤后关节炎也进行了评估。结果：单纯骨折13例，粉碎性骨折3例，行闭合复位后k针固定；6例单纯性骨折，7例粉碎性骨折行ORPF。所有患者主观结果满意，握力比对侧超过90%，TAM接近满。两组患者均实现骨愈合。CRKF术后1级创伤后关节炎5例，ORPF术后1级创伤后关节炎7例。结论：采用CRKF或ORPF治疗第五掌骨底关节内骨折均可获得满意的手术治疗效果。我们的数据显示，行CPKF的患者有良好的效果，在闭合复位失败后行ORPF的患者也有良好的效果。我们的经验表明，当CRKF不能以令人满意的方式完成时，ORPF可以作为备用计划。研究类型/证据水平：治疗性IV。

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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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.