Treatment of metacarpophalangeal intra-articular fractures assisted with metacarpophalangeal arthroscopy / 中华骨科杂志

ABSTRACT

Objective To explore the clinical results of metacarpophalangeal(MP) intra-articular fractures treatment assisted with MP arthroscopy. Methods Five patients suffered from MP joint fractures were treated with closed reduction and K-wire fixation under the MP arthroscopy. The age of the patients was from 17 to 53 years with an average of 23.5 years. There were four males and one female. All the fractures were caused by direct trauma. The head of metacarpal bone was injured in one case while the bases of proximal phalange were involved in four cases. 2 were of simple fractures and 3 of comminuted fractures. No joint surface defects were found preoperatively. The duration from injury to surgery was from 5 days to 3 weeks. The treatment results were evaluated with respect to MP arthroscopical findings, the fracture union and the postoperative function. Results The fracture lines could be seen in 4 cases under arthroscopy except one located at the palmar aspect of metacarpal head, which was then treated with open reduction and internal fixation. During the examination with MP arthroscopy, one case each of volar plate injury and collateral ligament injury was found. The patients were followed up 3-6 months with an average of 4.8 months postoperatively. All the patients obtained fracture union with a smooth joint surface. The motion of involved MP joints achieved nearly to their normal active range in 3 cases. No pain or snapping was found during the movement of MP joints. There was also no lateral instability. Only in one case, because of the massive and comminuted fracture, the involved finger was immobilized with plaster for five weeks, the ROM of MP joint became 90? for flexion and -56? for extension at 5 months postoperatively. Conclusion It is a less invasive procedure with good results to treat MP joint fractures assisted with MP arthroscopy. It is suitable for some acute MP intra-articular fractures.