Outcomes of Surgically Managed Carpometacarpal Injuries
Poster #: 094
Session/Time: A
Author:
Emilio Arduino Ihde, BS
Mentor:
Andrew Henebry, MD
Research Type: Clinical Research
Abstract
INTRODUCTION:
To investigate the functional outcomes and complications of operatively managed CMC joint injuries in a young, active population
METHODS:
A retrospective chart review of all patients undergoing surgical treatment CMC joint injuries at a single institution over a 6-year period was performed. Patients were excluded if they had a 1st CMC joint injury, were under 18 years old, or had incomplete documentation. Injury radiographs were categorized as simple/extra-articular, partial articular, and complete articular. Electronic health records were searched for demographic information, mechanism, associated injuries, time to surgery, time to union, time to return to full-activity, complications, and need for revision surgery. Quick Disabilities of Arm, Shoulder, and Hand Score (QuickDASH) and Patient Reported Wrist Evaluation (PRWE) were collected at final follow-up.
RESULTS:
A total of 160 patients were included in the study, of which 89% were male. Punching was the most common mechanism of injury. Combined 4th and 5th CMC joint injuries and isolated 5th CMC joint injuries encompassed 90% of the injury patterns seen. Combined 4th and 5th CMC joint injuries had an associated distal carpal row fracture 54.7% of the time. There was a 29.4% complication rate with the most common complication being related to Kirschner wires (K wire) 16.3%. Final follow-up was obtained on 45/160 patients (28%). Median final QuickDASH score was 11.4 (range 0-45.5), with 65% of patients meeting the patient acceptable symptomatic state (PASS). Median PWRE score of 18.5 (range 0-67.5) with 76% meeting the PASS. Among the 133 active duty military patients included, 79/133 (59%) remained on active duty at a median of 3.3 years postoperatively.
CONCLUSION:
Despite relatively high surgical complication rates, operative management of CMC injuries results in good-to-excellent functional outcomes.
To investigate the functional outcomes and complications of operatively managed CMC joint injuries in a young, active population
METHODS:
A retrospective chart review of all patients undergoing surgical treatment CMC joint injuries at a single institution over a 6-year period was performed. Patients were excluded if they had a 1st CMC joint injury, were under 18 years old, or had incomplete documentation. Injury radiographs were categorized as simple/extra-articular, partial articular, and complete articular. Electronic health records were searched for demographic information, mechanism, associated injuries, time to surgery, time to union, time to return to full-activity, complications, and need for revision surgery. Quick Disabilities of Arm, Shoulder, and Hand Score (QuickDASH) and Patient Reported Wrist Evaluation (PRWE) were collected at final follow-up.
RESULTS:
A total of 160 patients were included in the study, of which 89% were male. Punching was the most common mechanism of injury. Combined 4th and 5th CMC joint injuries and isolated 5th CMC joint injuries encompassed 90% of the injury patterns seen. Combined 4th and 5th CMC joint injuries had an associated distal carpal row fracture 54.7% of the time. There was a 29.4% complication rate with the most common complication being related to Kirschner wires (K wire) 16.3%. Final follow-up was obtained on 45/160 patients (28%). Median final QuickDASH score was 11.4 (range 0-45.5), with 65% of patients meeting the patient acceptable symptomatic state (PASS). Median PWRE score of 18.5 (range 0-67.5) with 76% meeting the PASS. Among the 133 active duty military patients included, 79/133 (59%) remained on active duty at a median of 3.3 years postoperatively.
CONCLUSION:
Despite relatively high surgical complication rates, operative management of CMC injuries results in good-to-excellent functional outcomes.