Efficacy evaluation of closed reduction of fifth metacarpal neck fractures in children
- Authors: Zhila N.G.1, Semenov S.J.2, Komarov K.M.2, Komarov P.B.2, Dumitrash V.G.2, But’ko P.V.1, Shabalov A.M.1
-
Affiliations:
- St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
- State Budgetary Institution of Healthcare “Children’s City Hospital No. 22”
- Issue: Vol 10, No 3 (2019)
- Pages: 75-79
- Section: Original studies
- URL: https://journals.rcsi.science/pediatr/article/view/15685
- DOI: https://doi.org/10.17816/PED10375-79
- ID: 15685
Cite item
Full Text
Abstract
This article covers the retrospective analysis of the results of treatment of 47 children aged 9 to 17 years with V metacarpal neck fractures, based on the data of radiation studies. The treatment of fifth metacarpal neck fractures, without reduction, does not have a reliable positive result. At large angles of deformity of the V neck of the metacarpal (>45°), the use of closed reduction leads to a significant positive therapeutic effect in the immediate observation period. However, from our point of view, the persistence of the displacement V metacarpal bone with sufficiently large degree in certain cases and the presence of posttraumatic changes in the structure of the heads, subcapital and growth zones in the observed patients cannot satisfy specialists from the standpoint of modern children’s traumatology. Thus, changes in the structure of the heads and subcapital zones in the long-term radiological control of the group were found in 11. 1% of patients who were treated without reduction with a stabilizing plaster cast and in 55% of patients who underwent closed reduction of the metacarpal fractures. The predominance of the narrowing of the growth zone of the injured V metacarpal bone occurs in patients who undergo a closed manual reduction, which may be due to the traumatic effect on the physical zone of the primary force or reduction manipulations. All this indicates the feasibility of further scientific research of this problem with the prospect of developing therapeutic technologies that allow to achieve a complete anatomical reposition of the metacarpal bones in pediatric patients.
Keywords
Full Text
##article.viewOnOriginalSite##About the authors
Nikolay G. Zhila
St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Author for correspondence.
Email: nzhila@list.ru
MD, PhD, Dr Med Sci, Honored Doctor of the Russian Federation, Professor, Department of Surgical Diseases of Childhood
Russian Federation, Saint PetersburgSergey Ju. Semenov
State Budgetary Institution of Healthcare “Children’s City Hospital No. 22”
Email: sergey2810@yandex.ru
Children surgeon
Russian Federation, Saint PetersburgKonstantin M. Komarov
State Budgetary Institution of Healthcare “Children’s City Hospital No. 22”
Email: koskoma@yandex.ru
MD, PhD, Chief, Department of Surgery
Russian Federation, Saint PetersburgPavel B. Komarov
State Budgetary Institution of Healthcare “Children’s City Hospital No. 22”
Email: pavelko@gmail.com
Orthopedic Traumatologist, Department of Surgery
Russian Federation, Saint PetersburgVyacheslav G. Dumitrash
State Budgetary Institution of Healthcare “Children’s City Hospital No. 22”
Email: dumvyacheslav@yandex.ru
Radiologist
Russian Federation, Saint PetersburgPavel V. But’ko
St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Email: pashbutcko@yandex.ru
Student, 6th Year, Pediatric Faculty
Russian Federation, Saint PetersburgAlexandr M. Shabalov
St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Email: Aleks-Shabalov2007@yandex.ru
MD, PhD, Department of Propaedeutics of Children’s Diseases
Russian Federation, Saint PetersburgReferences
- Дегтярь В.А., Сушко В.И., Мохов А.И., и др. Опыт лечения переломов пястных костей кисти y детей // Травма. – 2012. – Т. 13. – № 4. – С. 143–144. [Degtyar VA, Sushko VI, Mokhov AI, et al. Experience of metacarpal fractures treatment in children. Trauma. 2012;13(4):143–144. (In Russ.)]
- Шихалёва Н.Г., Чиркова И.В. Лечение больных с закрытыми переломами дистального метаэпифиза пястных костей с применением чрескостного остеосинтеза // Гений ортопедии. – 2009. – № 2. – С. 40–45. [Shikhaleva NG, Chirkova IV. Treatment of patients with the closed fractures of distal meta-epiphysis of metacarpal bones using transosseous osteosynthesis. Genij ortopedii. 2009;(2):40-45. (In Russ.)]
- Dobson P, Taylor R, Dunkin C. Safe splinting in hand surgery. Ann R Coll Surg Engl. 2011;93(1):94. https://doi.org/10. 1308/003588411X128516
- Godfrey J, Cornwall R. Pediatric metacarpal fractures. Instr Course Lect. 2017;66:437-445.
- Hays PL, Rozental TD. Rehabilitative strategies following hand fractures. Hand Clinics. 2013;29(4):585-600. https://doi.org/10. 1016/j.hcl.2013. 08. 011.
- Jahss SA. Fractures of the metacarpals: a new method of reduction and immobilization. J Bone Joint Surg. 1938;(20):178-186.
- James JI. The assessment and management of the injured hand. Hand. 1970;2(2):97-105. https://doi.org/10. 1016/0072-968x(70)90003-3.
- Nellans KW, Chung KC. Pediatric hand fractures. Hand Clin. 2013;29(4):569-578. https://doi.org/10. 1016/j.hcl.2013. 08. 009.
- Landin LA. Epidemiology of children fractures. J Pediatr Orthop B. 1997;6(2):79-83. https://doi.org/10. 1097/01202412-199704000-00002.
- Lowdon IM. Fractures of the metacarpal neck of the little finger. Injury. 1986;17(3):189-192. https://doi.org/10. 1016/0020-1383(86)90332-3.
- Richards T, Clement R, Russell I, Newington D. Acute hand injury splinting — the good, the bad and the ugly. Ann R Coll Surg Engl. 2018;100(2):92-96. https://doi.org/10. 1308/rcsann.2017. 0195.