Treatment of basilar part fractures of the fifth metacarpus with mini-external fixation system
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Objective To explore clinical effects of mini-external fixation system in the treatment of basilar part fractures of the fifth metacarpus. Methods From February 2005 to July 2013, 15 cases with the fifth metacarpal basilar fractures underwent open reduction and external fixation with mini-external fixation system. There were 9 males and 6 females. The average age was 32 years( range: 15-62 years). The time from injury to operation was 3 days( range: 1 hours-10 days). According to the Orthopaedic Trauma Association( OTA) classification, there were 8 cases of type A, 5 of type B I, and 2 of type C I. Patients were instructed with early postoperative functional rehabilitation exercises and checked with the X ray regularly after the operations. The mini-external fixation system were dismantled according to the postoperative fracture healing. The Total Active Motion( TAM) score of Chinese Medical Associaition was used to evaluate the range of motion of the joint. Results Primary healing was obtained in all incisions at the first atage. No infections or necrosis occurred postoperatively. Mild pin track infection occurred in 1 case. All patients were followed up from 6 to 24 months with an average of 13.2 months. All the fractures got bony union 6 to 12 weeks postoperatively, with an average of 7.2 weeks. No osteomyelitis, joint stiffness, malunion, nonunion and other complications were found. According to the functional evaluation of TAM scales, the results were excellent in 11, good in 3 and fair in 1. The excellent and good rate was 93.3%. Conclusions Mini-external fixation system in the treatment of basilar part fractures of the fifth metacarpus enjoys many advantages: simple operation, strong fixation, early functional exercise, satisfactory effects. It is a good option in clinic.