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Effects of postoperative early motion on the results of osteosynthesis with miniplates in metacarpal fractures

Year 2013, Volume: 4 Issue: 4, - , 01.12.2013
https://doi.org/10.5799/ahinjs.01.2013.04.0324

Abstract

Objectives: In our study, we aimed to evaluate the radiological and functional results of rigid internal fixation with mini plate osteosynthesis in the management of metacarpal fractures. Methods: In this study, 11 patients (10 males, 1 female) which were treated with mini plate osteosynthesis for metacarpal fracture (n=13) were evaluated retrospectively. The average age of patients was 35 years (range 25-46 years) with a mean follow-up of 1.4 years (range 1.1 to 2.2-years). Rehabilitation program was started on the postoperative second day. Range of motion was assessed according to the total active range of motion (TAROM) scale. Results: Eight patients (10 metacarpal) had excellent scores, two patients had good scores and one patient had moderate score at final follow-up. Time to union was found an average of 6 weeks (range 4-7 weeks). Complications did not observed such as loss of reduction, infection, circulatory disorders, neurological symptoms, osteonecrosis, sudeck atrophy. Conclusion: Rigid internal fixation with mini plate osteosynthesis could be performed in patients with metacarpal fractures with satisfactory radiological and functional results along with rehabilitation program contains passive and active joint movements initiated at early post-operative period. J Clin Exp Invest 2013; 4 (4): 457-462

References

  • Ada S, Bal E. El Kırıklarının Tedavisi. TOTBİD Derg 2004;3:1-11.
  • Kiliç A, Sökücü S, Basilgan S, et al. Outcomes of four distinct fixation methods in the conservative treatment of fifth metacarpal neck fractures. Ulus Travma Acil Cerrahi Derg 2012;18:167-170.
  • Nalbantoğlu U, Gereli A , BY Uçar , et al . Treatment of metacarpal fractures with open reduction and low- profile plate and screw fixation. Acta Orthop Trauma- tol Turc 2008;42:303-309.
  • Frick L, Mezzadri G, Yzem I, et al. Acute carpometa- carpal joint dislocation of the long fingers: study of 100 cases. Chir Main 2011;30:333-339.
  • Kömürcü M, Botanlıoğlu H, Kutay Özturan EK. Me- takarp Kırıkları. Turkiye Klinikleri J Surg Med Sci 2006;2:32-36.
  • Gereli A, Nalbantoğlu U, Türkmen M. Sporcularda görülen metakarp ve falanks kırıkları. TOTBİD Derg 2012;1:220-227.
  • Freeland AE, Orbay JL. Extraarticular hand fractures in adults: a review of new developments. Clin Orthop Relat Res 2006;445:133-145.
  • Fufa DT, Goldfarb CA. Fractures of the thumb and fin- ger metacarpals in athletes. Hand Clin 2012;28:379- 388.
  • Kamath JB, Vardhan H, Naik DM, et al. Modified bone tie: a new method to achieve interfragmentary compression in unstable oblique metacarpal and phalangeal fractures. Tech Hand Up Extrem Surg 2012;16:42-44.
  • Potenza V, Caterini R, De Maio F, et al. Fractures of the neck of the fifth metacarpal bone. Medium-term results in 28 cases treated by percutaneous trans- verse pinning. Injury 2012;43:242-245.
  • Lai Z, Shi SY, Wei W, et al. Case-control study on two different methods in the treatment of Bennett frac- tures. Zhongguo Gu Shang 2011;24:479-481.
  • Bennani A, Zizah S, Benabid M, et al. The inter- metacarpal double pinning in the surgical treatment of Bennett fracture (report of 24 cases). Chir Main 2012;31:157-162.
  • Sammer DM. Discussion: Prospective multicenter trial of modified retrograde percutaneous intramed- ullary Kirschner wire fixation for displaced metacar- pal neck and shaft fractures. Plast Reconstr Surg 2012;129:704-706.
  • Lieber J, Härter B, Schmid E, et al. Elastic Stable In- tramedullary Nailing (ESIN) of Pediatric Metacarpal Fractures: Experiences with 66 Cases. Eur J Pediatr Surg 2012;22:305-310.
  • Sletten IN, Nordsletten L, Husby T, et al. Isolated, ex- tra-articular neck and shaft fractures of the 4th and 5th metacarpals: a comparison of transverse and bouquet (intra-medullary) pinning in 67 patients. J Hand Surg Eur Vol 2012;37:387-395.
  • Kömürcü M , Alemdaroğlu B , Kürklü M , et al. Hand- gun injuries with metacarpal and proximal phalan- geal fractures: early definitive treatment. Int Orthop 2008;32:257-262.
  • Mumtaz MU, Farooq MA, Rasool AA, et al. Unstable metacarpal and phalangeal fractures: treatment by internal fixation using AO mini-fragment plates and screws. Ulus Travma Acil Cerrahi Derg 2010;16:334- 338.
  • Walter FL, Papandrea RF. A mini external fixator for hand and finger fractures constructed from read- ily available materials. Tech Hand Up Extrem Surg 2011;15:215-218.
  • Marsland D, Sanghrajka AP, Goldie B. Static monolat- eral external fixation for the Rolando fracture: a simple solution for a complex fracture. Ann R Coll Surg Engl 2012;94:112-115.
  • Pehlivan P, Cilli F, Mahirogullari M,Ozyurek S. Man- agement of Combined Open Fractures of Thumb Metacarpal and Trapezium (Surgical Tip). Hand. 2007; 2: 48-50.
  • Afshar R, Fong TS, Latifi MH, et al. A biomechanical study comparing plate fixation using unicortical and bicortical screws in transverse metacarpal fracture models subjected to cyclic loading. J Hand Surg Eur Vol. 2012;37:396-401.
  • Ochman S, Vordemvenne T, Paletta J, et al. Experi- mental fracture model versus osteotomy model in metacarpal bone plate fixation. ScientificWorldJournal 2011;11:1692-1698.
  • Fujitani R, Omokawa S, Shigematsu K, Tanaka Y. Comparison of the intramedullary nail and low-profile plate for unstable metacarpal neck fractures. J Orthop Sci 2012;17:450-456.
  • Soni A, Gulati A, Bassi JL, et al. Outcome of closed ipsilateral metacarpal fractures treated with mini frag- ment plates and screws: a prospective study. J Orthop Traumatol 2012;13:29-33.
  • Paulus C, Suero EM, Schütz L, et al. Outpatient treat- ment of metacarpal and phalangeal fractures leads to similar outcomes compared to inpatient treatment. Z Orthop Unfall 2011;149:550-553.

Mini plakla osteosentez uygulanan metakarp kırıklarında ameliyat sonrası erken hareketin fonksiyonel sonuçlara etkisi

Year 2013, Volume: 4 Issue: 4, - , 01.12.2013
https://doi.org/10.5799/ahinjs.01.2013.04.0324

Abstract

Amaç: Çalışmamızda mini plakla anatomik redüksiyon ve rijit internal fiksasyon uyguladığımız metakarp kırıklı hastaların fonksiyonel ve radyolojik sonuçlarını değerlendirmeyi amaçladık. Yöntemler: Çalışmada metakarp kırığı sonrası mini plakla osteosentez uygulanan 11 hasta (10 erkek, 1 kadın) retrospektif olarak değerlendirildi. Hastaların ortalama yaşı 35 (dağılım 25-46) ve ortalama takip süresi 1,4 (dağılım 1,1-2,2) yıldı. Bütün hastalara postoperatif ikinci gün aktif ve pasif eklem hareket açıklığı egzersizleri başlandı. Fonksiyonel sonuçlar total aktif eklem hareket açıklığı (TAEHA) skalasına göre değerlendirildi. Bulgular: TAEHA skalasına göre 8 hastada (10 metakarp) mükemmel, 2 hastada iyi, 1 hastada orta dereceli sonuç elde edildi. Ortalama 6 hafta (4-7 hafta) içinde bütün hastalarda kaynama görüldü. Redüksiyon kaybı, enfeksiyon, dolaşım bozukluğu, nörolojik araz, osteonekroz, sudeck atrofisi gibi komplikasyonlar görülmedi. Sonuç: Mini-plakla rijit internal osteosentez uygulanan metakarp kırıklı hastalarda, postoperatif erken dönemde aktif ve pasif eklem hareketlerinin başlanması ile tatmin edici radyolojik ve fonksiyonel sonuçlar elde edilebilir.

References

  • Ada S, Bal E. El Kırıklarının Tedavisi. TOTBİD Derg 2004;3:1-11.
  • Kiliç A, Sökücü S, Basilgan S, et al. Outcomes of four distinct fixation methods in the conservative treatment of fifth metacarpal neck fractures. Ulus Travma Acil Cerrahi Derg 2012;18:167-170.
  • Nalbantoğlu U, Gereli A , BY Uçar , et al . Treatment of metacarpal fractures with open reduction and low- profile plate and screw fixation. Acta Orthop Trauma- tol Turc 2008;42:303-309.
  • Frick L, Mezzadri G, Yzem I, et al. Acute carpometa- carpal joint dislocation of the long fingers: study of 100 cases. Chir Main 2011;30:333-339.
  • Kömürcü M, Botanlıoğlu H, Kutay Özturan EK. Me- takarp Kırıkları. Turkiye Klinikleri J Surg Med Sci 2006;2:32-36.
  • Gereli A, Nalbantoğlu U, Türkmen M. Sporcularda görülen metakarp ve falanks kırıkları. TOTBİD Derg 2012;1:220-227.
  • Freeland AE, Orbay JL. Extraarticular hand fractures in adults: a review of new developments. Clin Orthop Relat Res 2006;445:133-145.
  • Fufa DT, Goldfarb CA. Fractures of the thumb and fin- ger metacarpals in athletes. Hand Clin 2012;28:379- 388.
  • Kamath JB, Vardhan H, Naik DM, et al. Modified bone tie: a new method to achieve interfragmentary compression in unstable oblique metacarpal and phalangeal fractures. Tech Hand Up Extrem Surg 2012;16:42-44.
  • Potenza V, Caterini R, De Maio F, et al. Fractures of the neck of the fifth metacarpal bone. Medium-term results in 28 cases treated by percutaneous trans- verse pinning. Injury 2012;43:242-245.
  • Lai Z, Shi SY, Wei W, et al. Case-control study on two different methods in the treatment of Bennett frac- tures. Zhongguo Gu Shang 2011;24:479-481.
  • Bennani A, Zizah S, Benabid M, et al. The inter- metacarpal double pinning in the surgical treatment of Bennett fracture (report of 24 cases). Chir Main 2012;31:157-162.
  • Sammer DM. Discussion: Prospective multicenter trial of modified retrograde percutaneous intramed- ullary Kirschner wire fixation for displaced metacar- pal neck and shaft fractures. Plast Reconstr Surg 2012;129:704-706.
  • Lieber J, Härter B, Schmid E, et al. Elastic Stable In- tramedullary Nailing (ESIN) of Pediatric Metacarpal Fractures: Experiences with 66 Cases. Eur J Pediatr Surg 2012;22:305-310.
  • Sletten IN, Nordsletten L, Husby T, et al. Isolated, ex- tra-articular neck and shaft fractures of the 4th and 5th metacarpals: a comparison of transverse and bouquet (intra-medullary) pinning in 67 patients. J Hand Surg Eur Vol 2012;37:387-395.
  • Kömürcü M , Alemdaroğlu B , Kürklü M , et al. Hand- gun injuries with metacarpal and proximal phalan- geal fractures: early definitive treatment. Int Orthop 2008;32:257-262.
  • Mumtaz MU, Farooq MA, Rasool AA, et al. Unstable metacarpal and phalangeal fractures: treatment by internal fixation using AO mini-fragment plates and screws. Ulus Travma Acil Cerrahi Derg 2010;16:334- 338.
  • Walter FL, Papandrea RF. A mini external fixator for hand and finger fractures constructed from read- ily available materials. Tech Hand Up Extrem Surg 2011;15:215-218.
  • Marsland D, Sanghrajka AP, Goldie B. Static monolat- eral external fixation for the Rolando fracture: a simple solution for a complex fracture. Ann R Coll Surg Engl 2012;94:112-115.
  • Pehlivan P, Cilli F, Mahirogullari M,Ozyurek S. Man- agement of Combined Open Fractures of Thumb Metacarpal and Trapezium (Surgical Tip). Hand. 2007; 2: 48-50.
  • Afshar R, Fong TS, Latifi MH, et al. A biomechanical study comparing plate fixation using unicortical and bicortical screws in transverse metacarpal fracture models subjected to cyclic loading. J Hand Surg Eur Vol. 2012;37:396-401.
  • Ochman S, Vordemvenne T, Paletta J, et al. Experi- mental fracture model versus osteotomy model in metacarpal bone plate fixation. ScientificWorldJournal 2011;11:1692-1698.
  • Fujitani R, Omokawa S, Shigematsu K, Tanaka Y. Comparison of the intramedullary nail and low-profile plate for unstable metacarpal neck fractures. J Orthop Sci 2012;17:450-456.
  • Soni A, Gulati A, Bassi JL, et al. Outcome of closed ipsilateral metacarpal fractures treated with mini frag- ment plates and screws: a prospective study. J Orthop Traumatol 2012;13:29-33.
  • Paulus C, Suero EM, Schütz L, et al. Outpatient treat- ment of metacarpal and phalangeal fractures leads to similar outcomes compared to inpatient treatment. Z Orthop Unfall 2011;149:550-553.
There are 25 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

İbrahim Azboy This is me

Celil Alemdar This is me

Abdullah Demirtaş This is me

Emin Özkul This is me

Mehmet Gem This is me

Mehmet Bulut This is me

Publication Date December 1, 2013
Published in Issue Year 2013 Volume: 4 Issue: 4

Cite

APA Azboy, İ., Alemdar, C., Demirtaş, A., Özkul, E., et al. (2013). Mini plakla osteosentez uygulanan metakarp kırıklarında ameliyat sonrası erken hareketin fonksiyonel sonuçlara etkisi. Journal of Clinical and Experimental Investigations, 4(4). https://doi.org/10.5799/ahinjs.01.2013.04.0324
AMA Azboy İ, Alemdar C, Demirtaş A, Özkul E, Gem M, Bulut M. Mini plakla osteosentez uygulanan metakarp kırıklarında ameliyat sonrası erken hareketin fonksiyonel sonuçlara etkisi. J Clin Exp Invest. December 2013;4(4). doi:10.5799/ahinjs.01.2013.04.0324
Chicago Azboy, İbrahim, Celil Alemdar, Abdullah Demirtaş, Emin Özkul, Mehmet Gem, and Mehmet Bulut. “Mini Plakla Osteosentez Uygulanan Metakarp kırıklarında Ameliyat Sonrası Erken Hareketin Fonksiyonel sonuçlara Etkisi”. Journal of Clinical and Experimental Investigations 4, no. 4 (December 2013). https://doi.org/10.5799/ahinjs.01.2013.04.0324.
EndNote Azboy İ, Alemdar C, Demirtaş A, Özkul E, Gem M, Bulut M (December 1, 2013) Mini plakla osteosentez uygulanan metakarp kırıklarında ameliyat sonrası erken hareketin fonksiyonel sonuçlara etkisi. Journal of Clinical and Experimental Investigations 4 4
IEEE İ. Azboy, C. Alemdar, A. Demirtaş, E. Özkul, M. Gem, and M. Bulut, “Mini plakla osteosentez uygulanan metakarp kırıklarında ameliyat sonrası erken hareketin fonksiyonel sonuçlara etkisi”, J Clin Exp Invest, vol. 4, no. 4, 2013, doi: 10.5799/ahinjs.01.2013.04.0324.
ISNAD Azboy, İbrahim et al. “Mini Plakla Osteosentez Uygulanan Metakarp kırıklarında Ameliyat Sonrası Erken Hareketin Fonksiyonel sonuçlara Etkisi”. Journal of Clinical and Experimental Investigations 4/4 (December 2013). https://doi.org/10.5799/ahinjs.01.2013.04.0324.
JAMA Azboy İ, Alemdar C, Demirtaş A, Özkul E, Gem M, Bulut M. Mini plakla osteosentez uygulanan metakarp kırıklarında ameliyat sonrası erken hareketin fonksiyonel sonuçlara etkisi. J Clin Exp Invest. 2013;4. doi:10.5799/ahinjs.01.2013.04.0324.
MLA Azboy, İbrahim et al. “Mini Plakla Osteosentez Uygulanan Metakarp kırıklarında Ameliyat Sonrası Erken Hareketin Fonksiyonel sonuçlara Etkisi”. Journal of Clinical and Experimental Investigations, vol. 4, no. 4, 2013, doi:10.5799/ahinjs.01.2013.04.0324.
Vancouver Azboy İ, Alemdar C, Demirtaş A, Özkul E, Gem M, Bulut M. Mini plakla osteosentez uygulanan metakarp kırıklarında ameliyat sonrası erken hareketin fonksiyonel sonuçlara etkisi. J Clin Exp Invest. 2013;4(4).