Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone

Background To compare clinical and radiographic outcomes between intramedullary nail fixation and percutaneous K-wire fixation for fractures in the distal third portion of the metacarpal bone. Methods A single-institutional retrospective review identified 41 consecutive cases of metacar...

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Main Authors: Sung Jun Moon, Jae-Won Yang, Si Young Roh, Dong Chul Lee, Jin Soo Kim
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2014-11-01
Series:Archives of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2014.41.6.768
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author Sung Jun Moon
Jae-Won Yang
Si Young Roh
Dong Chul Lee
Jin Soo Kim
author_facet Sung Jun Moon
Jae-Won Yang
Si Young Roh
Dong Chul Lee
Jin Soo Kim
author_sort Sung Jun Moon
collection DOAJ
description Background To compare clinical and radiographic outcomes between intramedullary nail fixation and percutaneous K-wire fixation for fractures in the distal third portion of the metacarpal bone. Methods A single-institutional retrospective review identified 41 consecutive cases of metacarpal fractures between September 2009 and August 2013. Each of the cases met the inclusion criteria for closed, extra-articular fractures of the distal third of the metacarpal bone. The patients were divided by the method of fixation (intramedullary nailing or K-wire). Outcomes were compared for mean and median total active motion of the digit, radiographic parameters, and period until return to work. Complications and symptoms were determined by a questionnaire. Results During the period under review, 41 patients met the inclusion criteria, and the fractures were managed with either intramedullary nailing (n=19) or percutaneous K-wire fixation (n=22). The mean and median total active range of motion and radiographic healing showed no statistically significant difference between the two groups. No union failures were observed in either group. The mean operation time was shorter by an average of 14 minutes for the percutaneous K-wire fixation group. However, the intramedullary nailing group returned to work earlier by an average of 2.3 weeks. Complications were reported only in the K-wire fixation group. Conclusions Intramedullary nailing fixation is advisable for fractures in the distal third of the metacarpal bone. It provides early recovery of the range of motion, an earlier return to work, and lower complication rates, despite potentially requiring a wire removal procedure at the patient's request.
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spelling doaj.art-85f864acca784368923cb980d4fcd7452022-12-22T01:59:20ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712014-11-01410676877210.5999/aps.2014.41.6.768443Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal BoneSung Jun Moon0Jae-Won Yang1Si Young Roh2Dong Chul Lee3Jin Soo Kim4Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital, Gwangmyeong, KoreaHand and Micro Plastic Surgery, Gangnam Jaejun Plastic Clinic, Pyeongtaek, KoreaDepartment of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital, Gwangmyeong, KoreaDepartment of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital, Gwangmyeong, KoreaDepartment of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital, Gwangmyeong, KoreaBackground To compare clinical and radiographic outcomes between intramedullary nail fixation and percutaneous K-wire fixation for fractures in the distal third portion of the metacarpal bone. Methods A single-institutional retrospective review identified 41 consecutive cases of metacarpal fractures between September 2009 and August 2013. Each of the cases met the inclusion criteria for closed, extra-articular fractures of the distal third of the metacarpal bone. The patients were divided by the method of fixation (intramedullary nailing or K-wire). Outcomes were compared for mean and median total active motion of the digit, radiographic parameters, and period until return to work. Complications and symptoms were determined by a questionnaire. Results During the period under review, 41 patients met the inclusion criteria, and the fractures were managed with either intramedullary nailing (n=19) or percutaneous K-wire fixation (n=22). The mean and median total active range of motion and radiographic healing showed no statistically significant difference between the two groups. No union failures were observed in either group. The mean operation time was shorter by an average of 14 minutes for the percutaneous K-wire fixation group. However, the intramedullary nailing group returned to work earlier by an average of 2.3 weeks. Complications were reported only in the K-wire fixation group. Conclusions Intramedullary nailing fixation is advisable for fractures in the distal third of the metacarpal bone. It provides early recovery of the range of motion, an earlier return to work, and lower complication rates, despite potentially requiring a wire removal procedure at the patient's request.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2014.41.6.768metacarpal bonesfracture fixationintramedullaryfractures, closed
spellingShingle Sung Jun Moon
Jae-Won Yang
Si Young Roh
Dong Chul Lee
Jin Soo Kim
Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone
Archives of Plastic Surgery
metacarpal bones
fracture fixation
intramedullary
fractures, closed
title Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone
title_full Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone
title_fullStr Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone
title_full_unstemmed Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone
title_short Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone
title_sort comparison between intramedullary nailing and percutaneous k wire fixation for fractures in the distal third of the metacarpal bone
topic metacarpal bones
fracture fixation
intramedullary
fractures, closed
url http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2014.41.6.768
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