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HOME > J Musculoskelet Trauma > Volume 24(1); 2011 > Article
Original Article
Comparison of Early Fixation and Late Fusion of 4, 5th Carpometacarpal Joint in the Intra-Articular Fractures of 4th and 5th Metacarpal Base
Chang Ho Yi, M.D., Jin Rok Oh, M.D.
Journal of the Korean Fracture Society 2011;24(1):60-66.
DOI: https://doi.org/10.12671/jkfs.2011.24.1.60
Published online: January 21, 2011

Department of Orthopedic Surgery, Wonju College of Medicine, Yonsei University, Wonju, Korea.

Address reprint requests to: Jin Rok Oh, M.D. Department of Orthopedic Surgery, Yonsei University Wonju College of Medicine, 162, Ilsan-dong, Wonju 220-701, Korea. Tel: 82-33-741-1355·Fax: 82-33-746-7326, jroh@yonsei.ac.kr
• Received: July 24, 2010   • Revised: December 17, 2010   • Accepted: December 29, 2010

Copyright © 2011 The Korean Fracture Society

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  • Purpose
    To evaluate clinical results between early fixation group and delayed fusion group in treatment of intraarticular fracture of 4th, 5th metacarpal base.
  • Materials and Methods
    From March 2002 to December 2006, 21 cases of early fusion and 11 cases of delayed fusion of 4, 5th carpometacarpal joint were reviewed retrospectively or were included in this study. Average follow up period is 39.9 months. Bony union was checked by plain films at follow up. DASH-questionnaire, VAS pain scale, grip power and range of motion of 4th, 5th metacarpophalangeal joint were also checked at last follow up.
  • Results
    In radiologic study, bony union was confirmed in all cases of two groups. Early fixation group showed better outcomes than delayed fusion group in range of motion, DASH-questionnaire and VAS pain scale with statistical significant (p<0.004).
  • Conclusion
    Because early fixation group showed better clinical outcomes than delayed fusion group, early diagnosis and proper surgical treatment are important for better outcomes in treatment of intraarticular fracture of 4th, 5th metacarpal base.
  • Key words: 4th, 5th metacarpal base, Early fixation, Delayed fusion
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Fig. 1
Three-dimensional reconstruction image of computed tomography shows the intraarticular fractures occurred simultaneously in the fourth and fifth metacarpal base.
jkfs-24-60-g001.jpg
Fig. 2
24 year-old patient came with fractures in the fourth and fifth metacarpal base by traffic accident (A).
He diagnosed immediately at emergency department, so he was taken surgery at two day after trauma (B).
At postoperative 9 months, bony union was confirmed in plain film (C).
jkfs-24-60-g002.jpg
Fig. 3
18 year-old patient came with fractures in the fourth metacarpal base and hamate with dislocation of 4th, 5th carpometacarpal joint by traffic accident (A).
For firm fixation of hamate, 4th metacarpal bone and hamate were tied up together by hand mini plate & screws (B).
At postoperative 12 months, bony union was confirmed in plain film (C).
jkfs-24-60-g003.jpg
Fig. 4
54 year-old female came to outpatient department complained prolonged pain at the fourth and fifth metacarpal base area after fall down injury 2 months ago (A).
Because of non-union, she was taken arthrodesis with autoiliac bone graft with hand-mini plate and screws (B).
At postoperative 11 months, fused fourth and fifth carpometacarpal joint was confirmed in plain film (C).
jkfs-24-60-g004.jpg
Table 1
Comparison of results between immediate fixation group and delayed reconstruction group of intra-articular metacarpal base fractures of the fourth through fifth metacarpals
jkfs-24-60-i001.jpg

Figure & Data

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    • Fourth and Fifth Metacarpal Base Arthrodesis for Posttraumatic Arthritis of Fifth Carpometacarpal Joint
      Chul-Hyung Kang, Eun-Sok Son, Chul-Hyun Cho
      Journal of the Korean Society for Surgery of the Hand.2013; 18(4): 184.     CrossRef

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      Comparison of Early Fixation and Late Fusion of 4, 5th Carpometacarpal Joint in the Intra-Articular Fractures of 4th and 5th Metacarpal Base
      J Korean Fract Soc. 2011;24(1):60-66.   Published online January 31, 2011
      DOI: https://doi.org/10.12671/jkfs.2011.24.1.60
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    Comparison of Early Fixation and Late Fusion of 4, 5th Carpometacarpal Joint in the Intra-Articular Fractures of 4th and 5th Metacarpal Base
    Image Image Image Image
    Fig. 1 Three-dimensional reconstruction image of computed tomography shows the intraarticular fractures occurred simultaneously in the fourth and fifth metacarpal base.
    Fig. 2 24 year-old patient came with fractures in the fourth and fifth metacarpal base by traffic accident (A). He diagnosed immediately at emergency department, so he was taken surgery at two day after trauma (B). At postoperative 9 months, bony union was confirmed in plain film (C).
    Fig. 3 18 year-old patient came with fractures in the fourth metacarpal base and hamate with dislocation of 4th, 5th carpometacarpal joint by traffic accident (A). For firm fixation of hamate, 4th metacarpal bone and hamate were tied up together by hand mini plate & screws (B). At postoperative 12 months, bony union was confirmed in plain film (C).
    Fig. 4 54 year-old female came to outpatient department complained prolonged pain at the fourth and fifth metacarpal base area after fall down injury 2 months ago (A). Because of non-union, she was taken arthrodesis with autoiliac bone graft with hand-mini plate and screws (B). At postoperative 11 months, fused fourth and fifth carpometacarpal joint was confirmed in plain film (C).

    Fig. 1

    Fig. 2

    Fig. 3

    Fig. 4

    Comparison of Early Fixation and Late Fusion of 4, 5th Carpometacarpal Joint in the Intra-Articular Fractures of 4th and 5th Metacarpal Base

    Comparison of results between immediate fixation group and delayed reconstruction group of intra-articular metacarpal base fractures of the fourth through fifth metacarpals
    Table 1 Comparison of results between immediate fixation group and delayed reconstruction group of intra-articular metacarpal base fractures of the fourth through fifth metacarpals

    Table 1

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