ABSTRACT

We aimed to present the clinical and functional results of the surgical treatment for fractures of the thumb metacarpal base.

Patients who were operated at our clinic for unstable thumb metacarpal intra-articular base fractures with closed reduction and percutaneous pinning and who completed their follow-ups were included in the study. Patients with open fractures, fractures or injuries in the hands or same extremities were excluded from the study. The type of the fracture, its relativity with the joint, demographic data, number and configuration of the wires used, time of surgery, postoperative time to fixation, and complications were evaluated. In the objective evaluation, intra-articular step-off, presence of post-traumatic pain, and pinch and gripping strengths compared with the uninjured side were investigated.

The mechanism of injury in 28 patients [26 males and 2 females; mean age, 31 y (range, 19–61 years); 11 left-sided and 17 right-sided] was noted as fall in 27 and motorcycle accident in 1. Mean time to operation was 7 d (range, 1–18 days). K-wires were used for fixation in all cases. A loss of 20% in the pinching and gripping strength was observed in two and one patient, respectively, compared with the uninjured side. Revision surgery was performed in one patient due to fixation failure. Superficial pin tract infection was observed in two patients; both cases resolved with wound dressing and oral antibiotics.

Unstable fractures of the thumb base are common in hand surgery practices, and treatment using closed reduction and percutaneous K-wire fixation provides safe and satisfactory results.

Keywords: Thumb, metacarpus, fracture, fixation, percutaneous