Open vs. closed reduction with pinning for displaced Rockwood and Wilkins' type C thumb metacarpal base fractures in children.

Background: The treatment of severely displaced Rockwood and Wilkins' type C (RWC) thumb metacarpal basal fractures remains controversial in children. This retrospective study aimed to compare the efficacy of two treatment methods, open vs. closed reduction with pinning of such injuries. Methods: This study included 30 patients with open physes, 14 boys and 16 girls, who all received either closed or open reduction treatment. The primary outcomes of interest included healing time, complications, and functional results, which were evaluated using the improved Mayo score standard. The minimum follow-up period was 24 months, with a mean of 30.3 months (range 24.0-45.0 months). Statistical significant was defined as Results: All fractures were healed within 7 weeks after surgery, regardless of which surgical approach was used. However, the recovery time was markedly faster in the closed group, with a mean of 4.2 weeks, than in the open group, with a mean of 4.7 weeks ( Conclusion: The data from the open group and closed group procedures for severely shifted RWC fractures in children indicate comparable prognoses and complication rates between the two groups. Obviously closed reduction, in particular, offers several advantages over open procedure, including shorter surgical duration, fewer K-wires required, and no need for open incisions. Consequently, closed reduction is the preferred method for treating such RWC fractures.