J Korean Fract Soc.  2010 Oct;23(4):367-372. 10.12671/jkfs.2010.23.4.367.

Percutaneous Retrograde Intramedullary Pin Fixation for Isolated Metacarpal Shaft Fracture of the Little Finger

Affiliations
  • 1Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea. hsoohong@hanmail.net

Abstract

PURPOSE
To evaluate the anatomic and functional outcome of retrograde intramedullary single wire fixation for metacarpal shaft fractures of the little finger.
MATERIALS AND METHODS
hirty one consecutive patients with closed metacarpal shaft fractures of the little finger who have been treated with retrograde intramedullary single wire fixation were evaluated. Fracture union and angulation were analyzed radiologically, and clinical evaluations were performed including range of motion, DASH score and complications.
RESULTS
Fracture union was achieved in all cases and callus formation was obvious at postoperative 41 days. Average angulation of fracture site was 3degrees in the coronal plane and 1.2degrees in the sagittal plane at the last follow up and no measurable metacarpal shortening was observed. Mean TAM was 253degrees and DASH score was 2.6. There were two cases of pin migration as intermediate complications.
CONCLUSION
Closed reduction with subsequent percutaneous retrograde K-wire fixation produced good radiological and functional results. We recommend this minimally invasive technique which provides adequate fixation of displaced little finger metacarpal shaft fractures with good functional results and low morbidity.

Keyword

Metacarpal shaft fracture; Little finger; K-wire; Retrograde fixation

MeSH Terms

Bony Callus
Fingers
Follow-Up Studies
Humans
Range of Motion, Articular

Figure

  • Fig. 1 1.6 mm K-wire is inserted from metacarpal head with metacarpophalangeal joint flexion for easy access to the medullary canal.

  • Fig. 2 When the wire tip passes fracture site and reaches to metacarpal base, wrist is bent maximum and further penetration is performed to proximal area.

  • Fig. 3 The distal end of k-wire is pulled up to metacarpal head.

  • Fig. 4 Proximal wire tip is bent over, cut and buried under the skin.

  • Fig. 5 Pin was migrated to the metacarpophalangeal joint in postoperative 4 weeks (A). After 6 months, complete bone healing occurred without loss of reduction (B).


Cited by  1 articles

The Treatment Outcomes of the Metacarpal Shaft and Neck Comminuted Fractures Using Modified Percutaneous Retrograde Intramedullary Kirschner Wire Fixation
Seok Woo Hong, Young Ho Lee, Min Bom Kim, Goo Hyun Baek
Arch Hand Microsurg. 2018;23(3):175-183.    doi: 10.12790/ahm.2018.23.3.175.


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