Analysis of Operative Techniques of Fractures of the First Metacarpal Base.

Abstract:

INTRODUCTION:Over time, the operative treatment of extra-articular and intra-articular fractures of the first metacarpal base has gained significant importance, and at present, there are many operative strategies available because of the different osteosynthesis procedures in practice today. PURPOSE:In this retrospective cohort study, we analyze the possible differences between 2 distinguished operative osteosynthesis techniques, in terms of patient outcome, operation time, duration of radiation exposure, and postoperative radiographic results. METHODS:Fifty-two patients operated on for first metacarpal extra-articular or intra-articular base fracture were investigated retrospectively by means of records. After reduction, osteosynthesis was performed on 34 patients with K-wires (group I), and on 18 patients with plates and/or screws (group II). Of the 52 patients, 19 were available for a prospective follow-up examination. RESULTS:After analyzing the operation time, a significant difference between the 2 operative techniques for epibasal and Bennett fractures (P = 0.0089 and P = 0.02) was recorded. Furthermore, for the time of radiation exposure, no significant difference could be detected. Also, no statistical difference was found between the 2 analyzed groups in terms of patient outcomes and postoperative radiographic results. CONCLUSIONS:The determined data of the operated extra-articular and intra-articular first metacarpal base fractures revealed approximately equal results for patient outcome, postoperative x-ray results, and time of radiation exposure during the operation. After analyzing the operation time of epibasal and Bennett fractures, we can recommend that the K-wire fixation is superior to the plate and/or screw osteosynthesis as a treatment, because of the associated benefits of keeping costs low without harming the patient in the long term.

journal_name

Ann Plast Surg

authors

Fischborn T,Beckenbauer D,Held M,Daigeler A,Medved F

doi

10.1097/SAP.0000000000001293

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

507-514

issue

5

eissn

0148-7043

issn

1536-3708

journal_volume

80

pub_type

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