Percutaneous Pinning in Acute Hamatometacarpal Fracture-Dislocations: Mid-Term Functional and Radiological Results

Abstract

Objectives: We aimed to evaluate the mid-term functional and radiological results of acute hamatometacarpal (HMC) fracture dislocations retrospectively, treated with closed reduction and percutaneous pinning Methods: A total of 18 patients were included in the study. The mean patient age was 29.8±7.9 (range: 18–42). All patients were male. HMC joint five was affected in 14 patients while HMC joints four and five were affected in four patients. All dislocations were dorsal. The affected metacarpals were transversely fixed to neighbouring healthy metacarpals and carpometacaral joints. The K-wires and splints were removed during the fifth or sixth week postsurgery. Results: The mean interval between injury and surgery was 3.6±2 days (range: 1–8), mean follow-up time was 21±7.5 months (range: 12-36). The mean DASH score was 3.7±3.3 (range: 0–12), and VAS score was 1.2±1.1 (range: 0–4). The mean grip strength was 42±4.2 kg (range: 35–53), the mean grip strength of healty side was 43.9±3.9 (range:37-51). Compared to the healthy side, there was no statistically significant difference in wrist extension (p: 0.001), flexion (p: 0.002) or grip strength (p: 0.017). Reduction was maintained in all cases, and there were no redisplacements. Conclusions: We think that, with early diagnosis and in the absence of a large hamate fracture, closed reduction and fixation with percutaneous K-wires is a sufficient method to address HMC fracture-dislocations. In sum, this method ensures a simple, easy and quick procedure.