Adequate Care of Fractures Near the Base of the First Metacarpal Bone: Clinical Study of 160 Patients

Abstract

160 fractures near the base of the first metacarpal bone were treated between 1990 and December 2000. There were 119 men and 41 women with an average of age of 35 years. Of the 62 intra-articular fractures, 28 were treated operatively, usually with K-wires. From 44 Bennett fractures 20 were operated, of 12 Rolando fractures 8 were managed operatively. Finally 2 comminuted fractures and 4 other intraarticular fractures were treated conservatively. Patients with intra-articular fractures treated by operation had better clinical and radiological results. 18 of the 20 operated patients with Bennett fractures had an anatomical fracture healing and 16 had no complaints. Of the 24 conservatively treated Bennett fractures merely 8 had clinical and radiological good results. The rest of the patients had a fracture dislocation. 7 of the 8 operated Rolando fractures had an anatomic joint reduction and 4 had no complaints, 3 had sensitivity to weather changes. Both conservatively treated comminuted fractures and 2 of the not classified fractures had bad radiological and clinical results. The most common problem of the extra-articular fractures was the angulation and the joint shift. The clinical results are independent from the radiological findings. The patients were asked about sensitivity to weather changes, loss of strength and strain-related pain.

Key words

Bennett fracture - Rolando fracture - first carpometacarpal joint - fractures of the saddle

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