Research Articles

Functional and Radiological Outcomes of First Metacarpal Fractures Treated with Minimally Invasive Reduction and Osteosynthesis System

Abstract

Background: First metacarpal base fractures, comprising 4% of hand fractures, pose treatment challenges due to the thumb’s functional importance. This study evaluates the functional and radiological outcomes of the Minimally Invasive Reduction and Osteosynthesis System (MIROS) for these fractures.
Methods: A prospective study was conducted on 30 patients with first metacarpal base fractures treated with MIROS at a single institute from June 2022 to October 2024, with a 6-month follow-up. Patients aged ≥≥18 years with closed fractures were included; open fractures were excluded.

Results: Functional outcomes, assessed by the Kapandji score, showed 80% of patients achieving a perfect score of 10 (mean: 9.85 ± 0.46). Radiographic union occurred at a mean of 5.13 ± 1.30 weeks. Extra-articular fractures had the best outcomes, while Rolando fractures showed reduced function.
Conclusion: MIROS demonstrated excellent results, with high functional scores, early mobilization, minimal complications, and faster union compared to traditional fixation techniques. It is a reliable, minimally invasive option for managing first metacarpal base fractures, particularly for extra-articular and Bennett types, although Rolando fractures may require more rigid fixation strategies.

1. Stanton JS, Dias JJ, Burke FD. Fractures of the tubular bones of the hand. J Hand Surg Eur Vol. 2007;32(6):626-36. doi: 10.1016/j.Jhse.2007.06.017. [PubMed: 17993422].
2. Brown MT, Rust PA. Fractures of the thumb metacarpal base. Injury. 2020;51(11):2421-8. doi: 10.1016/j.injury.2020.07.053. [PubMed: 32741606].
3. Gustilo RB, Merkow RL, Templeman D. The management of open fractures. J Bone Joint Surg Am. 1990;72(2):299-304. [PubMed: 2406275].
4. Kapandji A. Clinical test of apposition and counter-apposition of the thumb. Ann Chir Main. 1986;5(1):67-73. doi: 10.1016/s0753- 9053(86)80053-9. [PubMed: 3963909].
5. De Jonge JJ, Kingma J, Van Der Lei B, Klasen HJ. Fractures of the metacarpals. A retrospective analysis of incidence and aetiology and a review of the English-language literature. Injury. 1994;25(6):365-9. doi: 10.1016/0020-1383(94)90127-9. [PubMed: 8045639].
6. Deuschl J, Alfort H, Wilcke M. The Epidemiology of Metacarpal Fractures: A Descriptive Study Based on 18,802 Fractures From the Swedish Fracture Register. J Hand Surg Glob Online. 2025;7(4):100725. doi: 10.1016/j.jhsg.2025.02.015. [PubMed: 40497267]. [PubMed Central: PMC12150039].
7. D. Shah H, Gupta A. Orthogonal dual plating for fracture of base of 1st metacarpal- original study. Surg Update: Int J Surg Orthop. 2018;4(4):165-8. doi: 10.17511/ijoso.2018.i04.06.
8. Greeven APA, Van Groningen J, Schep NWL, Van Lieshout EMM, Verhofstad MHJ. Open reduction and internal fixation versus closed reduction and percutaneous fixation in the treatment of Bennett fractures: A systematic review. Injury. 2019;50(8):1470-7. doi: 10.1016/j.injury.2019.06.027. [PubMed: 31288938].
9. Brüske J, Bednarski M, NiedźwiedźZ, Zyluk A, Grzeszewski S. The results of operative treatment of fractures of the thumb metacarpal base. Acta Orthop Belg. 2001;67(4):368-73. [PubMed: 11725569].
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IssueVol 12 No 1 (2026) QRcode
SectionResearch Articles
Keywords
Bone Fracture Closed Fracture Reduction Metacarpal Bones
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How to Cite
1.
Vyas R, Patel M, Desai T, Tailor D, Pandya D, Thakkar C. Functional and Radiological Outcomes of First Metacarpal Fractures Treated with Minimally Invasive Reduction and Osteosynthesis System. J Orthop Spine Trauma. 2026;12(1):15-18.