The triad of multiple metacarpal fractures and/or dislocations of the fingers, severe hand swelling and clinical evidence of acute median nerve dysfunction.
Twenty-five cases of crush injury to the hand resulting in the triad of multiple finger metacarpal fractures/dislocations of the fingers, a balloon hand appearance due to severe swelling and clinical evidence of acute median nerve dysfunction were retrospectively reviewed. All were men with a mean age of 33 (range 20-45) years. All injuries occurred following industrial or major car accidents. The fracture site included metacarpal head/neck fractures, metacarpal shaft fractures and carpometacarpal joint fracture-dislocations. All patients underwent fasciotomies, open carpal tunnel release and fixation of displaced fractures, followed by immediate mobilisation of the fingers. At a mean final follow-up of 7 (range 6-8) months, full recovery of median nerve function was seen in all patients. The final mean total active motion of the fingers was 243 degrees , 230 degrees and 250 degrees in displaced distal, middle and proximal impact fractures, respectively. All patients were able to return back to work.
King Saud University, Riyadh, Saudi Arabia. moqattan@hotmail.com
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Al-Qattan
D000062:Accidents, Occupational; D000063:Accidents, Traffic; D000208:Acute Disease; D000328:Adult; D004487:Edema / Q000150:complications*; D005383:Finger Injuries / Q000601:surgery; D050723:Fractures, Bone / Q000150:complications / Q000601:surgery*; D006230:Hand Injuries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000601:surgery*; D008297:Male; D008475:Median Nerve / Q000293:injuries* / Q000601:surgery; D050279:Metacarpal Bones / Q000293:injuries* / Q000601:surgery; D008875:Middle Aged; D016059:Range of Motion, Articular; D013001:Somatoform Disorders; D055815:Young Adult