Abstract
Background To evaluate the clinical and radiological results of closed reduction, distraction using an external fixator, and percutaneous fixation in patients with Bennet and Rolando fractures. Methods Patients over 18 years of age, who had isolated fracture at the base of the first metacarpal bone, had no previous functional limitations and pain complaints, were regularly followed up, and had fixation using K-wire combined with an external fixator, were included. Arthrosis was evaluated according to Eaton and Littler classification. Pain intensity was evaluated using the visual analogue scale (VAS) on a 0–10 scale. Furthermore, patients were questioned regarding limitations in their daily activities and hobbies. Pinch and grasp strengths were evaluated. Results Thirteen of the patients were male and five were female, with a mean age of 31.5 ± 12.5 years. The surgical procedure was performed on the right extremity in 12 patients and left extremity in six patients. Twelve patients were found to have Bennet fractures, whereas six patients had Rolando fractures. The mean follow-up period of the patients was found to be 29.6 ± 5.4 months. The VAS score was rated as 2 in one patient and 1 in one patient. Other patients had a pain VAS score of 0. The mean Quick-DASH score was calculated to be 1.20. No statistical difference was found in pinch strength between the two extremities (p > 0.05). No difference was observed in terms of the range of motion (p > 0.05). Conclusion Fixation using K-wire combined with an external fixator has more benefits than its disadvantages and is superior to other methods in the intra-articular fractures of the first metacarpal bone.
Highlights
To evaluate the clinical and radiological results of closed reduction, distraction using an external fixator, and percutaneous fixation in patients with Bennet and Rolando fractures
A total of 18 patients meeting the study criteria, who had proximal end intra-articular extension fracture at the first metacarpal bone and were treated with an external fixator and percutaneous pinning between 2016 and 2019, were included in the study. irteen of the patients were male and five were female, with a mean age of 31.5 ± 12.5 years. e surgical procedure was performed on the right extremity in 12 patients and left extremity in six patients. e affected extremity was the dominant extremity in 14 patients. e mechanism of injury was occupational accidents in five patients, traffic accident in four patients, battery in two patients, and falling in seven patients
Distraction using an external fixator and Kirschner wires (K-wire) fixation provide safe stability for early postoperative rehabilitation of the fractures at the base of the first metacarpal bone. ese methods are useful in early rehabilitation of the joint movements and full recovery of functional capacity. e high bone union rates and low rate of joint degeneration obtained by the method applied in the present study indicate that this method is effective
Summary
To evaluate the clinical and radiological results of closed reduction, distraction using an external fixator, and percutaneous fixation in patients with Bennet and Rolando fractures. Patients over 18 years of age, who had isolated fracture at the base of the first metacarpal bone, had no previous functional limitations and pain complaints, were regularly followed up, and had fixation using K-wire combined with an external fixator, were included. Is study aimed to evaluate the clinical and radiological results of closed reduction, distraction using an external fixator, and percutaneous fixation in patients with intra- and extra-articular fractures at the base of the first metacarpal bone. 2. Materials and Methods is retrospective study conducted over a two-year period included all Bennett-type or Rolando-type intra-articular fractures at the base of the first metacarpal bone. At the 24-week controls, VAS was applied to all patients to measure the pain intensity, and the shortened version of the disabilities of the arm, shoulder, and hand questionnaire (Quick-DASH) was performed to evaluate physical functions subjectively
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