FRACTURES OF THE BASE OF THE FIRST METACARPAL BONE:REUSLTS OF SURGICAL TREATMENT

Journal of the Korean Society for Surgery of the Hand 2000;5(2):191-195.
Published online June 1, 2000.

Ho Jung Kang, Young Jin Seo, Soo Bong Hahn, Eung Shick Kang

제1수지 중수골 기저부골절의 수술적 치료

강호정, 서영진, 한수봉, 강응식

Abstract

The purpose of this article is to describe the results of operative treatment of fractures of the base of the first metacarpal bone. All patients with a fracture of the base of the first metacarpal who were treated at our hospital between April 1991 and August 1999 were included in a retrospective study at an average follow-up time of 14months. In the study period, 26 patients had undergone surgical treatment: 25 men, 1 women with a mean age of 37years(9～4). These were classified: fifteen Bennett's fractures, two Rolando's fractures, three extra-articular fractures and six epiphyseal injuries. Closed reduction and pinning was used for fifteen cases. The other eleven cases were treated with open reduction followed by pinning or external fixation. During the follow-up examination, five of the thirteen patients with a Bennett's fracture which were treated with closed methods were found to have significant complications. One of the five patients with epiphyseal injury which was treated with open reduction and pinning showed angulation and shortening. The patients with Rolando's fracture and extra-articular fracture were completely complaint free. In this series, although all of the patients with Bennett's fracture treated with open reduction were free of symptoms or disability, 38% patients treated with closed method had complications such as limited joint motion and pain. The results of operative treatment in Rolando's fractures and extra-articular fractures seemed quite satisfactory. Our study demonstrated that the higher quality of reduction correlated to less radiographic arthritic changes in intra-articular fractures at the base of the first metacarpal. But we found no significant correlation between degree of radiographic arthritic changes and clinical symptoms.