Intra-articular metacarpal head fractures.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Radiology

Background:

• Intra-articular metacarpal head fractures are common hand injuries.
• Accurate classification is crucial for effective treatment planning.

Purpose of the Study:

• To present and classify intra-articular metacarpal head fractures based on anatomical involvement.
• To evaluate treatment strategies for complex fractures.

Main Methods:

• Retrospective review of 103 intra-articular metacarpal head fractures in 100 patients.
• Classification based on roentgenographic examination.
• Analysis of fracture types including epiphyseal, avulsion, osteochondral, oblique, vertical, horizontal, comminuted, boxer's, loss of substance, and occult compression.

Main Results:

• A diverse range of intra-articular metacarpal head fracture types were identified.
• Fractures included epiphyseal (Salter-Harris type III), ligament avulsions, osteochondral, oblique, vertical, horizontal, comminuted, boxer's fractures, loss of substance, and occult compression with avascular necrosis.

Conclusions:

• Reconstruction to achieve a congruous metacarpal head is essential for large intra-articular defects.
• Early mobilization of the digit post-reconstruction is recommended when technically feasible.