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.