Percutaneous elastic intramedullary nailing of metacarpal fractures: Surgical technique and clinical results study
<p>Abstract</p> <p>Background</p> <p>We reviewed our results and complications of using a pre-bent 1.6 mm Kirschner wire (K-wire) for extra-articular metacarpal fractures. The surgical procedure was indicated for angulation at the fracture site in a true lateral radiogr...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2011-07-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Online Access: | http://www.josr-online.com/content/6/1/37 |
| _version_ | 1828137606511067136 |
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| author | Farook Mohamed Z Mohammed Riazuddin Newman Kevin |
| author_facet | Farook Mohamed Z Mohammed Riazuddin Newman Kevin |
| author_sort | Farook Mohamed Z |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>We reviewed our results and complications of using a pre-bent 1.6 mm Kirschner wire (K-wire) for extra-articular metacarpal fractures. The surgical procedure was 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.</p> <p>Methods</p> <p>A single K-wire is pre-bent in a lazy-S fashion with a sharp bend at approximately 5 millimeters and a longer smooth curve bent in the opposite direction. An initial entry point is made at the base of the metacarpal using a 2.5 mm 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.</p> <p>The wire is usually removed with pliers post-operatively at four weeks in the fracture clinic.</p> <p>Results</p> <p>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.</p> <p>Conclusions</p> <p>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.</p> |
| first_indexed | 2024-04-11T18:22:30Z |
| format | Article |
| id | doaj.art-d29d5e3a0e9b4c109f8368ca0c06fdee |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T18:22:30Z |
| publishDate | 2011-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-d29d5e3a0e9b4c109f8368ca0c06fdee2022-12-22T04:09:44ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2011-07-01613710.1186/1749-799X-6-37Percutaneous elastic intramedullary nailing of metacarpal fractures: Surgical technique and clinical results studyFarook Mohamed ZMohammed RiazuddinNewman Kevin<p>Abstract</p> <p>Background</p> <p>We reviewed our results and complications of using a pre-bent 1.6 mm Kirschner wire (K-wire) for extra-articular metacarpal fractures. The surgical procedure was 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.</p> <p>Methods</p> <p>A single K-wire is pre-bent in a lazy-S fashion with a sharp bend at approximately 5 millimeters and a longer smooth curve bent in the opposite direction. An initial entry point is made at the base of the metacarpal using a 2.5 mm 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.</p> <p>The wire is usually removed with pliers post-operatively at four weeks in the fracture clinic.</p> <p>Results</p> <p>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.</p> <p>Conclusions</p> <p>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.</p>http://www.josr-online.com/content/6/1/37 |
| spellingShingle | Farook Mohamed Z Mohammed Riazuddin Newman Kevin Percutaneous elastic intramedullary nailing of metacarpal fractures: Surgical technique and clinical results study Journal of Orthopaedic Surgery and Research |
| title | Percutaneous elastic intramedullary nailing of metacarpal fractures: Surgical technique and clinical results study |
| title_full | Percutaneous elastic intramedullary nailing of metacarpal fractures: Surgical technique and clinical results study |
| title_fullStr | Percutaneous elastic intramedullary nailing of metacarpal fractures: Surgical technique and clinical results study |
| title_full_unstemmed | Percutaneous elastic intramedullary nailing of metacarpal fractures: Surgical technique and clinical results study |
| title_short | Percutaneous elastic intramedullary nailing of metacarpal fractures: Surgical technique and clinical results study |
| title_sort | percutaneous elastic intramedullary nailing of metacarpal fractures surgical technique and clinical results study |
| url | http://www.josr-online.com/content/6/1/37 |
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