Keywords
first metacarpal bone
intra-articular fractures
osteosynthesis
How to Cite
Abstract
Background. The peculiarities of the anatomical and functional structure, the high incidence of trauma to the first metacarpal bone, and unsatisfactory treatment outcomes have led to numerous studies on the pathology of this localization. These studies provide opportunities for improving treatment methods and minimizing trauma during different stages of medical care.
Objective. This study aimed to conduct a retrospective analysis of the surgical treatment of first metacarpal fractures based on literature and clinical studies.
Materials and Methods. The study was based on data obtained from searches in the bibliographic databases Medline, PubMed, and EMBAS. A total of 29 literature sources dedicated to the surgical treatment of first metacarpal fractures were identified.
Results and Discussion. A selective retrospective analysis of treatment outcomes for first metacarpal fractures in medical institutions of Dnipro and Kryvyi Rih revealed that among 43 patients, the conservative treatment method was preferred in 27 cases, while surgical treatment was chosen in 16 cases. The obtained data indicate a tendency toward favoring closed reduction methods and plaster immobilization, as well as limited use of open reduction and internal fixation with mini-plates and percutaneous fixation with external fixation devices.
Conclusions. Fractures of the first metacarpal bone with intra-articular and peri-articular localization remain a relevant issue actively discussed in the literature, with no universally accepted solution due to the persistence of complications and functional disorders in the post-traumatic period. The variety of conservative and surgical methods currently used for treating fractures of the first metacarpal bone highlights the need for clear indications for their application, prioritizing techniques that ensure stable fragment fixation and early functional recovery. A retrospective analysis of treatment outcomes for first metacarpal fractures based on data from medical institutions demonstrates a stronger tendency toward conservative treatment, frequent use of Kirschner wire fixation, and rather limited application of osteosynthesis with external fixation devices and mini-plates.
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