Tension Band Wiring for Treatment of Extra Articular Fracture of the Base of First Metacarpal

Eleven patients with unstable extra-articular fractures of the base of the first metacarpal with angulations more than 30° uncorrected by closed reduction were treated by open reduction and tension band fixation. Ten men and one woman with a mean age of 36.18 years. Fall on a stretched hand was the cause in eight while a punch in two and trauma from a basket ball in one. The mean follow up period was 12.45 months. All fractures united within a mean of 4.36 weeks. Patients were evaluated by subjective and objective criteria: the mean of pain was 0.5, quick-DASH was 10.48 and Kapandji score was 9.8. While the mean of the grip strength was 94 % and the pinch strength was 99 % of the contra lateral hand. There were no complications except local irritation of the k-wires in two patients that had to be removed at 4 months. Tension band technique proved to be a valuable technique which is easy to apply and gives rigid fixation with early mobilization.