Functional and radiological outcomes of multiple dorsal carpometacarpal fracture dislocations treated with open reduction and internal fixation
Mehmet Ali Talmaç1, Mehmet Akif Görgel1, Ferdi Dırvar2, Okan Tokgozoglu3, Hacı Mustafa Özdemir1
1Department of Orthopedics and Traumatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
2Department of Orthopedics and Traumatology, Metin Sabancı Baltalimanı Bone Diseases Training and Research Hospital, Istanbul, Turkey
3Department of Orthopedics and Traumatology, Altunizade Acıbadem Hospital, Istanbul, Turkey
Keywords: Carpometacarpal fracture dislocations, grip strength, internal fixation, Quick Disabilities of the Arm, Shoulder, and Hand questionnairee.
Objectives: This study aims to evaluate the clinical and r adiological r esults o f p atients w ith m ultiple d orsal carpometacarpal (CMC) joint fracture dislocations treated with open reduction and internal fixation (ORIF).
Patients and methods: We evaluated 14 patients (12 males, 2 females; mean age 35.1 years; range, 22 to 64 years) between January 2013 and December 2017. Our main outcome measurements were the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, loss of grip strength, limitation of range of motion (ROM), and Kellgren-Lawrence osteoarthritis classification identified with radiographs and computed tomography images.
Results: The mean QuickDASH scores at seventh week and third month were 73.57 (range, 65-90) and 29.11 (range, 25-42.5), respectively. The mean QuickDASH score at seventh, ninth, and 12th month, and final follow-up was 4.64 (range, 0-30) and the QuickDASH score at these follow-up points was not 0 for only three patients. The mean loss of grip strength was 32.14% and two patients (14.29%) had limitation of ROM in third proximal interphalangeal joint at final followup. Four patients had grade I, nine patients had grade II, and one patient had grade III osteoarthritis according to Kellgren- Lawrence classification at final follow-up.
Conclusion: Although functional results demonstrated that multiple CMC joint fracture dislocations can be treated with ORIF, the high rate of osteoarthritis is a disadvantage.