Isolated, extra-articular neck and shaft fractures of the 4th and 5th metacarpals: a comparison of transverse and bouquet (intra-medullary) pinning in 67 patients
| Autor: | Hebe Désirée Kvernmo, Johan C. Hellund, Ida Neergård Sletten, Lars Nordsletten, Torstein Husby, R. A. Ødegaard |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Medullary cavity Radiography Bone Nails law.invention Intramedullary rod Fracture Fixation Internal Fractures Bone Young Adult Grip strength law Hand strength Fracture fixation medicine Humans Range of Motion Articular Pain Measurement Hand Strength business.industry Hand Injuries Metacarpal Bones Fracture Fixation Intramedullary Surgery Transverse plane Female Range of motion business |
| Zdroj: | Journal of Hand Surgery (European Volume). 37:387-395 |
| ISSN: | 2043-6289 1753-1934 |
| Popis: | Although extra-articular metacarpal fractures are common, there is no consensus on the mode of treatment. We evaluated the outcome in 67 patients operated for isolated, extra-articular fractures in the neck or shaft of the ulnar two metacarpals 28 months post-operatively. There were 22 bouquet (intra-medullary) pinnings and 45 transverse pinnings; 11 were lost to follow-up. Overall, hand function was good, and no difference was detected between the two methods ( QuickDASH, grip strength, range of motion, VAS pain and VAS satisfaction). Many patients suffered complications: 12% had a superficial infection (all treated with transverse pinning with wires left exposed); 39% had some impairment in skin sensation; 29% reported cold intolerance; and 10% had other complications. Due to the potential risk of a secondary fracture of the neighbouring metacarpal after transverse pinning, we recommend bouquet (intra-medullary) pinning. We also recommend burying wires beneath the skin surface to avoid infection. |
| Databáze: | OpenAIRE |
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