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KMID : 1143020180230030175
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Archives of Hand and Microsurgery
2018 Volume.23 No. 3 p.175 ~ p.183
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The Treatment Outcomes of the Metacarpal Shaft and Neck Comminuted Fractures Using Modified Percutaneous Retrograde Intramedullary Kirschner Wire Fixation
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Hong Seok-Woo
Lee Young-Ho
Kim Min-Bom
Baek Goo-Hyun
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Abstract
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Purpose: The purpose of the present study was to verify the therapeutic efficiency of modified percutaneous retrograde intramedullary fixation using Kirschner wire in metacarpal shaft and neck comminuted fractures.
Methods: A total of 17 cases in 15 patients with metacarpal shaft and neck comminuted fractures diagnosed by physical examination and imaging modalities were included. For radiologic evaluations, the changes of degree of metacarpal bone shortening and that of dorsal angulation of metacarpal bone between before and six months after surgery were measured. Clinical evaluations were assessed by the timing of clinical union and visual analog scale (VAS), total active range of motion (TAM) of metacarpophalangeal joint, and complications at six months postoperatively.
Results: In all cases, union was achieved without additional treatment. The degree of the metacarpal bone shortening and the degree of dorsal angulation of metacarpal bone were improved significantly at six months after operation. The clinical bone union was completed average 6.49 weeks after surgery. The mean VAS was 1.35, and the mean TAM of metacarpophalangeal joint was 85.88° at 6 months postoperatively. Complications including nonunion, malunion, and refracture were not observed during follow-up period.
Conclusion: Modified percutaneous retrograde intramedullary fixation using Kirschner wire showed satisfactory treatment results in metacarpal shaft and neck comminuted fractures. Thus, this method could be recommended as one of treatment modalities for metacarpal shaft and neck comminuted fractures due to its easy procedures and low occurrence rate of associate complications.
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KEYWORD
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Metacarpal neck, Metacarpal shaft, Comminuted fracture, Retrograde, Intramedullary nailing
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