Mansour, M., El Hadidy, M., Ali Salem, A., Yoounes, R. (2023). A Comparison between Open Versus Closed Reduction in the Treatment of Fractures of the Base of the First Metacarpal Bone. The Egyptian Journal of Plastic and Reconstructive Surgery, 47(3), 201-206. doi: 10.21608/ejprs.2023.309718
Mohamed S Mansour; Mohammed R El Hadidy; Ali S Ali Salem; Reda A. A. Yoounes. "A Comparison between Open Versus Closed Reduction in the Treatment of Fractures of the Base of the First Metacarpal Bone". The Egyptian Journal of Plastic and Reconstructive Surgery, 47, 3, 2023, 201-206. doi: 10.21608/ejprs.2023.309718
Mansour, M., El Hadidy, M., Ali Salem, A., Yoounes, R. (2023). 'A Comparison between Open Versus Closed Reduction in the Treatment of Fractures of the Base of the First Metacarpal Bone', The Egyptian Journal of Plastic and Reconstructive Surgery, 47(3), pp. 201-206. doi: 10.21608/ejprs.2023.309718
Mansour, M., El Hadidy, M., Ali Salem, A., Yoounes, R. A Comparison between Open Versus Closed Reduction in the Treatment of Fractures of the Base of the First Metacarpal Bone. The Egyptian Journal of Plastic and Reconstructive Surgery, 2023; 47(3): 201-206. doi: 10.21608/ejprs.2023.309718
A Comparison between Open Versus Closed Reduction in the Treatment of Fractures of the Base of the First Metacarpal Bone
1The Department of Plastic Surgery*, Al-Azhar Teaching Hospital
2Department of Plastic Surgery; Mansoura Unisersity
3General Surgery Department, Faculty of Medicine, Mansoura University
4Plastic Surgery Department, Faculty of Medicine, ZagazigUniversity
Abstract
Background: Fracture of the thumb occurs most frequently. Thumb damage is expected to occur in 4% of hands fractures, while thumb impairment as a whole reduces 22% of body function. 20% of all fractures of the first metacarpal are caused by the Rolando fracture. Treatment of these fractures is still controversial. There are numerous different surgical therapy options. Objective: To find an effective method for treating bone fractures in the first metacarpal base. Patients and Techniques: This study included 40 patients presented with a fracture at the base of the first metacarpal bone at Plastic Surgery Department, Mansoura University and Al-Azhar Hospital. Patients were divided into closedloop < br />reduction fixed with K-wire (group A), open reduction and internal fixation with plate and screw (group B). Results: Bennet fracture was the most frequent type. First week postoperative follow-up there were statistically significant higher rate of edema, pain, and movement limitation in the open group (group B). Range of movement in open group < br />(group B) was significantly lower than closed group (group < br />A). Conclusion: K-wire Fixation is a beneficial treatment option for a comminuted fracture of the first metacarpal base. The optimum approach would be to combine closed anatomic reduction with effective K-wire fixation of the fracture fragments with early mobilization to prevent joint stiffness.
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