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[Fracture of the base of the first metacarpus].

The authors report a group of 73 cases of fractures of the base of the first metacarpal treated between 1974 and 1989. Fifty-three articular fractures (73%) and 20 non-articular fractures are described. Sixty-eight patients were treated surgically: 49 diverging pin insertions were used, 15 Lars Thoren technique, 5 rigid osteosyntheses with AO miniaturized material. Forty-two patients were seen again after one year or more. We classify the results as follows: very good: 29 (69%), good: 10 (24%), bad: 3 (7%). The relative simplicity, the reliability and the good results of the double diverging pin insertion lead the authors to apply this method in most fractures of the base of the first metacarpal, either articular or extra-articular.

Adolescent↗

Osteoid osteoma of the metacarpus. A case report.

The authors present a case of osteoid osteoma which is of interest not only because of the extreme rarity of its localisation in the 1st metacarpal, but also because of its unusual clinical features. These consisted of atypical pain, which was constant and did not respond to salicylates. There was marked local reaction, particularly in the soft tissues surrounding the 1st metacarpal, with a fine superficial venous reticulum. It was possible to follow the complete radiographic development of the tumour from its earliest stage to its final rather atypical appearance, and this allowed us to make the presumptive diagnosis without dependence on other more sophisticated methods.

Adult↗

[Bone healing after oblique osteotomy of the metacarpus in 6-week-old calves after conservative treatment or osteosynthesis].

Bone healing in infants treated by a rigid osteosynthesis of AO type showed mostly a marked periosteal and endosteal callus formation. In adults a callus formation is seldom seen and primary bone healing is mainly based on direct conduction of Havarian channels. Periosteal callus formation is even judged as a sign of instability in adults. We did à 2:1 osteotomy of the right metacarpal bone in 48 calves of 6 weeks of age. The treatment consisted in reposition and a plaster (6) in osteosynthesis with a metal screw of AO type (6) or a biodegradable screw of polylactid (36). The animals were sacrified 1-6 weeks postoperatively and a histological study was done in a comparative way based on the most common criteria in the literature of osteology and traumatology. In calves bones healing takes about 4-6 weeks even if the treatment is conservative or if there is a progressive dislocation in the first two postoperative weeks. A periosteal and endosteal callus formation is seen in every instance, even after interfragmentary compression by metal or biodegradable screws. All the results of biodegradable screws are at least as good as with metallic screws, at least in the growing skeleton. The force applied for interfragmentary compression does not lead to primary bone healing in the growing skeleton of young calvess.

Animals↗

[Fractures of the base of the first metacarpus].

The authors report a group of 73 cases of fractures of the base of the first metacarpal treated between 1974 and 1989. Fifty-three articular fractures (73%) and 20 non-articular fractures are described. Sixty-eight patients were treated surgically: 49 diverging pin insertions were used, 15 Lars Thoren technique, 5 rigid osteosyntheses with AO miniaturized material. Forty-two patients were seen again after one year or more. We classify the results as follows: very good: 29 (69%), good: 10 (24%), bad: 3 (7%). The relative simplicity, the reliability and the good results of the double diverging pin insertion lead the authors to apply this method in most fractures of the base of the first metacarpal, either articular or extra-articular.

Adolescent↗

[Cancellous bone grafting for fingers and metacarpus].

Bone grafting using cancellous bone is a reliable method treating fresh and old fractures. In the period 1974-1977 the Department of Plastic Surgery of the University Hospital "Bergmannsheil Bochum" treated 39 cases of finger- and metacarpal-bone injuries and bone diseases successfully by cancellous bone grafting. Indications, technique and results of our methods are described.

Adult↗