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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(02): 198-204
DOI: 10.1055/s-0040-1714229
Artigo Original
Mão

Osteosynthesis of Fractures of the Metacarpal Neck with Self-Compressing Screw - Preliminary Analysis of 21 Cases[*]

Article in several languages: português | English
Celso Ricardo Folberg 
1   Grupo de Cirurgia da Mão, Serviço de Ortopedia e Traumatologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
,
Jairo André de Oliveira Alves 
1   Grupo de Cirurgia da Mão, Serviço de Ortopedia e Traumatologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
,
Otávio Pereira Cadore 
2   Serviço de Ortopedia e Traumatologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
,
Fernando Maurente Sirena 
1   Grupo de Cirurgia da Mão, Serviço de Ortopedia e Traumatologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
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Abstract

Objective The present study aims to analyze the clinical results of the surgical treatment of metacarpal neck fractures with retrograde intramedullary fixation using cannulated headless screws (Herbert type).

Methods Retrospective study of 21 closed fractures deviated from the metacarpal neck in 21 patients operated between April 2015 and November 2018.

Results The sample included 19 men and 2 women. The mechanisms that caused the trauma were punching, falling to the ground and motor vehicle accident (n = 14, 5 and 2). The affected metacarpals were the 5th, 3rd, and 2nd (n = 19, 1 and 1). Surgical indications were neck-shaft diaphysis of the metacarpal > 30° for the 2nd and 3rd metacarpals and > 40° for the 5th metacarpal, shortening ≥ 5mm, rotational deviation, and the desire of the patient not to use plaster cast. In the immediate postoperative period, patients remained without immobilization and were instructed to mobilize their fingers according to tolerance. All patients had total active mobility > 240° and returned to their former occupations. All fractures consolidated and there were no reinterventions.

Discussion The great advantages of the headless screw technique are its low morbidity, sufficient stability to avoid external immobilization, and reproducibility at low cost.

Conclusion This is an easy, fast technique that has excellent results for the surgical treatment of displaced fractures of the neck of the metacarpals.

Keywords

fractures, bone - hand - metacarpus

* Work developed at the Hand Surgery Group, Orthopedics and Traumatology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.




Publication History

Received: 17 January 2020

Accepted: 05 May 2020

Article published online:
31 March 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 License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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