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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(06): 717-725
DOI: 10.1055/s-0041-1729568
Artigo Original
Mão

Intramedullary Fixation with Headless Screws versus Bouquet in Unstable Metacarpal Neck Fractures in Active Patients: A Randomized Study

Article in several languages: português | English
Marcio Aurelio Aita 
1   Departamento de Cirurgia da Mão, Faculdade de Medicina do ABC, Santo André, SP, Brasil
,
Ricardo Kaempf de Oliveira 
2   Departamento de Cirurgia de Mão, Hospital Santa Casa de Porto Alegre, Porto Alegre, RS, Brasil
,
Bruno Gianordoli Biondi 
3   Divisão de Cirurgia da Mão e Microcirurgia, Departamento de Cirurgia - Ortopedia e Trauma, Faculdade de Medicina do ABC, Santo André, SP, Brasil
,
João Pedro Farina Brunelli 
4   Departamento de Cirurgia De Mão, Hospital Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Gustavo Mantovanni Ruggiero 
5   Departamento de Cirurgia Plástica, Universita Degli Studi Di Milano, Milano, Itália
,
Pedro Jose Delgado 
6   Unidade de Cirurgia De Mão, Hospital Universitario Madrid Montepr Príncipe, CEU San Pablo University, Boadilla del Monte, Madrid, Espanha
› Author Affiliations Funding There was no financial support from public, commercial, or non-profit sources.
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Abstract

Objeticve To compare the range of motion (ROM), return-to-work time, visual analogue score (VAS), disability of the arm, shoulder, and hand (QuickDASH), and radiographic outcomes of two methods of definitive internal fixation in active patients with boxer's fractures, operated in the first week.

Methods This was a prospective, randomized trial, in which 50 patients, with a mean age range of 18 to 40 years old, were randomized and treated to definitive intramedullary fixation using 2 headless screws (n = 20) or bouquet (2 or 3 Kirschner wires) (n = 20). The patients were assessed on return-to-work time, ROM, patient reported QuickDASH outcome, VAS, and radiographic evaluation at 6 months.

Results At 6 months, there were no differences between the two groups in terms of ROM, postoperative pain (VAS), or QuickDASH score. The overall complication rate was 4.76% in the screw group, compared with 5% in the bouquet-fixation group.

Conclusions In the treatment of the active patients with unstable boxer's fractures, headless screws and bouquet fixation proved to be a safe and reliable treatment. The outcomes were similar in both groups.

Keywords

metacarpal bones - boxer's fracture - fracture fixation, intramedullary - minimally invasive surgical procedures - clinical trials, randomized

Note

Work developed at the Department of Hand Surgery, Hospital Universitário da Faculdade de Medicina do ABC, Santo André, SP, Brazil and Hospital Mãe de Deus, Porto Alegre, RS, Brazil.




Publication History

Received: 26 April 2020

Accepted: 09 October 2020

Article published online:
07 December 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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