Arch Hand Microsurg.  2019 Dec;24(4):321-329. 10.12790/ahm.2019.24.4.321.

Mini-Open Reduction of Isolated Metacarpal Bone Fracture

• Jeong YJ
• Oh SY
• Choi JS
• Lim JS
• Shim HS

• KMID: 2464467
• DOI: http://doi.org/10.12790/ahm.2019.24.4.321

Abstract

PURPOSE
Metacarpal bone fracture is a commonly encountered. The authors applied a minimally invasive open reduction technique that comprises only a stab incision to treat metacarpal bone fractures, thereby minimizing complications that accompany traditional open reduction methods while retaining the advantages of closed reduction techniques.
METHODS
A 5-year retrospective study was carried out of all patients who underwent surgical treatment performed by two separate hand surgeons. Total 37 patients were operated. Fourteen patients of conventional open reduction group and 23 patients of minimal invasive group were included in the study.
RESULTS
Mini-open reduction group had shorter operative time, comparable radiological reduction result, lower subjective pain, comparable mean active range of motion of the metacarpophalangeal joint, similar complication rate and superior outcome scar quality than conventional open reduction group.
CONCLUSION
Mini-open reduction method may be an alternative to conventional open reduction in treating metacarpal fractures.

Keyword

Metacarpal fracture; Open reduction; Internal fixation; Closed reduction; Kirschner wire

MeSH Terms

Cicatrix
Fractures, Bone*
Hand
Humans
Metacarpophalangeal Joint
Methods
Operative Time
Range of Motion, Articular
Retrospective Studies
Surgeons

Figure

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  Fig. 1 Depending on the severity of the fracture, a 4 to 6-hole plate along with 8 to 12 mm screws were used for bicortical plate fixation.

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  Fig. 2 Reached the fracture site with gentle dissection using the Freer elevator.

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  Fig. 3 The fractured segment was then reduced to appropriate position through simultaneous distal traction of the involved finger and direct palpation using the elevator.

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  Fig. 4 After comfirmed reduction and alignment, authors further advanced the initially inserted K-wire to reach the opposite side of the metacarpal base.

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  Fig. 5 In patients with unfavorable fractures, K-wires are inserted transverse direction while maintaining the reduction with Freer elevator.

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