International Wrist Center, Universidad Andres Bello, Santiago, Chile.
Santa Casa de Misericórdia Hospital, Porto Alegre, Brazil.
Tech Hand Up Extrem Surg. 2022 Dec 1;26(4):232-239. doi: 10.1097/BTH.0000000000000390.
Nonunion is a rare complication of metacarpal fractures and is usually associated with compound, open fractures with tissue loss and infection, or after failed surgical treatment. Repair by rigid osteosynthesis with plate and screws combined with autologous bone grafting has always been the treatment of choice for most patients. Such method allows early motion, although it has been proven that the presence of hardware may cause local soft tissue irritation. Often, hardware removal and tendon releases are necessary. We describe an original technique with a fixation method for the treatment of metacarpal nonunions, considering the excellent results attained with an intramedullary, headless screw for metacarpal fracture fixation. We report a series of three cases that evolved to bone healing with excellent clinical, functional, and radiographic outcomes.
骨折不愈合是掌骨骨折的罕见并发症,通常与伴有组织缺失和感染的复合性、开放性骨折,或经手术治疗失败有关。大多数患者的首选治疗方法是通过钢板和螺钉的刚性骨内固定结合自体骨移植进行修复。这种方法允许早期运动,尽管已经证明硬件的存在可能会引起局部软组织刺激。通常,需要去除硬件和肌腱松解。我们描述了一种原始的固定方法,用于治疗掌骨骨折不愈合,该方法考虑到用于掌骨骨折固定的无头髓内螺钉获得了出色的效果。我们报告了一系列 3 例病例,这些病例均发展为骨愈合,获得了极佳的临床、功能和影像学结果。