Collateral ligament avulsion fractures from the heads of the metacarpals of the fingers.
Nineteen patients with collateral ligament avulsion fractures from the metacarpal heads of the fingers were treated during a 6 year period. Seven undisplaced fractures were initially treated conservatively. Four united with full movement. Three required internal fixation for symptomatic non-union and healed without problems. Eleven patients with displaced fractures were treated by primary internal fixation using a single lag screw through a dorsal approach. Seven of these achieved a full range of movement of the injured digit by 3 months. Four patients failed to regain full flexion of the metacarpophalangeal joint. One patient with a displaced and comminuted fracture was treated with internal fixation at 8 weeks when the fragment had consolidated. As with similar fractures from the proximal phalangeal bases, these fractures are prone to non-union when treated conservatively, even when undisplaced. If fixation becomes necessary, the delay of a trial of conservative treatment does not appear to affect the outcome. Internal fixation of displaced fractures allows gentle mobilisation and facilitates union.
Shewring
D J
DJ
Department of Orthopaedic Surgery, University Hospital of Wales, Cardiff, UK. david.shewring@virgin.net.co.uk
Thomas
R H
RH
D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D017885:Collateral Ligaments / Q000293:injuries* / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D008297:Male; D008662:Metacarpophalangeal Joint / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D013165:Splints; D016896:Treatment Outcome