The purpose of this study was to determine the accuracy of fluoroscopic imaging during closed reduction and percutaneous fixation of intra-articular thumb metacarpal fractures. Closed reduction and percutaneous fixation was assessed in eight simulated intra-articular thumb metacarpal fractures, using fluoroscopy and digital radiographs. Displacement and fracture step-off were measured during fluoroscopy, on plain radiographs, and by direct visualization after careful dissection. Displacement on fluoroscopy was 0.8 (SD 1.0) mm and 1.2 (SD 1.4) with radiographic imaging. Direct visualization showed displacement of 0.9 (SD 1.2) mm. Intra-articular step-off on fluoroscopy was 0.8 (SD 1.0) mm and 0.8 (SD 0.8) with radiographic imaging. Direct visualization showed an intra-articular step-off of 0.8 (SD 1.2) mm. Statistical analysis showed excellent compatibility between fluoroscopy and direct visualization. Fluoroscopic visualization during surgery provides an adequate assessment of articular step-off and displacement in comparison with radiographs and direct visualization.
Keywords: Bennett fracture; closed reduction; fluoroscopy; percutaneous fixation; step-off.