Miltenberg Benjamin, Nemirov Daniel, Siddiqui Hassan, Kasper Alexis, Ilyas Asif M
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA USA.
J Hand Surg Glob Online. 2023 Sep 9;6(1):27-30. doi: 10.1016/j.jhsg.2023.08.003. eCollection 2024 Jan.
Metacarpal fractures are common injuries of the hand that often require operative repair. However, there is a paucity of data regarding the rate of reoperation and circumstances following metacarpal repair.
A retrospective review of all metacarpal fracture cases performed at a single academic institution between 2017 and 2021 was performed. All patients with isolated, acute metacarpal fractures were included for review. Data on patient demographics, fracture morphology, surgical technique, rate of early reoperation, and reason for reoperation were collected.
A total of 499 patients were identified to have undergone operative treatment for an isolated metacarpal fracture with an average follow-up of 4.2 months. The rate of unplanned early reoperation was 8.0% (n = 40), with seven patients requiring revision fracture surgery and 33 patients undergoing removal of symptomatic hardware. Mean and median time to reoperation was 2.1 and 1.5 months, respectively. The rate of reoperation for fractures of the metacarpal shaft was significantly lower than that of other fracture locations. Among the 40 revision cases, one case was following percutaneous fixation while 39 cases were following open reduction and internal fixation. Other demographic factures and fracture characteristics failed to show significant correlations to the rate of reoperation.
An unplanned early reoperation rate of 8.0% after operative fixation of acute metacarpal fractures was observed with the majority involving cases of removal of symptomatic hardware and an average time to reoperation of approximately 2.1 months. This information can be used to counsel patients and set expectations about the potential for metacarpal fracture surgeries.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognosis 2b.
掌骨骨折是手部常见损伤，常需手术修复。然而，关于掌骨修复后的再次手术率及相关情况的数据较少。
对2017年至2021年在某单一学术机构进行的所有掌骨骨折病例进行回顾性研究。纳入所有孤立性急性掌骨骨折患者进行分析。收集患者人口统计学数据、骨折形态、手术技术、早期再次手术率及再次手术原因等资料。
共确定499例患者接受了孤立性掌骨骨折的手术治疗，平均随访4.2个月。计划外早期再次手术率为8.0%（n = 40），其中7例患者需要进行骨折翻修手术，33例患者接受了有症状内固定物取出术。再次手术的平均时间和中位时间分别为2.1个月和1.5个月。掌骨干骨折的再次手术率显著低于其他骨折部位。在40例翻修病例中，1例为经皮固定后，39例为切开复位内固定后。其他人口统计学因素和骨折特征与再次手术率未显示出显著相关性。
急性掌骨骨折手术固定后计划外早期再次手术率为8.0%，大多数情况为有症状内固定物取出，再次手术平均时间约为2.1个月。这些信息可用于向患者提供咨询，并设定关于掌骨骨折手术潜在情况的预期。
研究类型/证据水平：预后2b级。
