Treatment the fractures of the base of the first metacarpal with mini external fixator / 中华骨科杂志

ABSTRACT

Objective To introduced the clinical application and indication of treatment the fractures of the base of the first metacarpal with mini external fixator. Methods From October 2002 to December 2004, 37 cases of different typical fractures of the base of the first metacarpal were treated with mini external fixator and followed up, which included type Ⅰ (Bennett fracture) 19 cases, type Ⅱ (Rolando fracture) 10 cases, type Ⅲ 8 cases. Defferent operations were applicated accroding to the fresh degree and classification of fractures. In type Ⅰ and fresh type Ⅱ fractures, closed reduction and fixation with mini external fixator were applicated at first. If the reduction was insatisfied, open reduction and fixation with Kirschner wire and external fixator were necessary. In old type Ⅱ fractures, open reduction associating internal and external fixation was applicated. In fresh type Ⅲ fractures, close and external fixation were applicated. In old type Ⅲ fractures, open reduction and external fixation were done. Results All the cases were followed up average 15 monthes and all the fractures were union successfully. The average union time were 5.5 weeks and 7.5 weeks in the fresh and old fractures. Function evaluation was made according to pain degree, thumb joint activity and proportion of traumatic arthritis. The overall good-excellent rate was 94.6%, the clinical results were satisfactory. Conclusion Treatment of fractures of the base of the first metacarpal with mini external fixator is better than conventional methods. This method is simple and reliable, and may shorten heal time, decrerase joint pain, limitation of joint movement and proportion of traumatic arthritis. It is an effective method in treatment of fractures of the base of the first metacarpal.