Percutaneous elastic intramedullary nailing of metacarpal fractures: Surgical technique and clinical results study.
Published: 19 July 2011
We reviewed our results and complications of using a pre-bent 1.6mm Kirschner wire (K-wire) for extra-articular metacarpal fractures. The surgical procedure is indicated for angulation at the fracture site in a true lateral radiograph of at least 30 degrees and/or in the presence of a rotatory deformity. A single K-wire is pre-bent in a lazy-S fashion with a sharp bend at approximately 5 millimetres and a longer smooth curve bent in the opposite direction. An initial entry point is made at the base of the metacarpal using a 2.5mm drill by hand. The K-wire is inserted blunt end first in an antegrade manner and the fracture reduced as the wire is passed across the fracture site. With the wire acting as three-point fixation, early mobilisation is commenced at the metacarpo-phalangeal joint in a Futuro hand splint. The wire is usually removed with pliers post-operatively at four weeks in the fracture clinic. We studied internal fixation of 18 little finger and 2 ring finger metacarpal fractures from November 2007 to August 2009. The average age of the cohort was 25 years with 3 women and 17 men. The predominant mechanism was a punch injury with 5 diaphyseal and 15 metacarpal neck fractures. The time to surgical intervention was a mean 13 days (range 4 to 28 days). All fractures proceeded to bony union. The wire was extracted at an average of 4.4 weeks (range three to six weeks). At an average follow up of 8 weeks, one fracture had to be revised for failed fixation and three superficial wound infections needed antibiotic treatment. With this simple and minimally invasive technique performed as day-case surgery, all patients were able to start mobilisation immediately. The general outcome was good hand function with few complications.
Similar Posts:
- Repair of olecranon fractures using fiberWire without metallic implants: report of two cases
- Efficacy of radial styloid targeting screws in volar plate fixation of intra-articular distal radial fractures: a biomechanical study in a cadaver fracture model
- High energy tibial plateau fractures treated with hybrid external fixation
- The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures
- Review of Fixation Techniques for the Four-part Fractured Proximal Humerus in Hemiarthroplasty
Tags: Metacarpal Fractures, Results