J Korean Fract Soc.  2021 Jan;34(1):23-29. 10.12671/jkfs.2021.34.1.23.

Clinical Outcomes of Customized Staple Fixation Using K-wire in Metacarpal Base or Neck Fractures

Affiliations
  • 1Department of Orthopedic Surgery, Good Samsun Hospital, Busan, Korea

Abstract

Purpose
This study was designed to evaluate the radiological and clinical outcomes of a new surgical technique—customized staple fixation using K-wire—in displaced metacarpal neck or base fractures.
Materials and Methods
From November 2016 to May 2017, 13 unstable metacarpal neck and base fractures (10 patients) were treated with II-shaped customized K-wire staples fixation, after performing open reductions through minimal dorsal incisions. The radiological and clinical outcomes were retrospectively evaluated.
Results
A mean of 2.6 staples were used for each fracture fixation. Preoperative angulation of 36.3°was reduced to 3.1° postoperatively. A week after surgery, the volar short arm splint was replaced with a dorsal splint to initiate active range of motion exercise, and the splint was subsequently removed after 3 weeks. The radiologic union was achieved at a mean of 5.1 weeks, and total active motion was recovered at a mean of 7.4 weeks. On a mean, K-wire staples were removed at 16.5 weeks after the surgery, and the mean treatment took 18.6 weeks. At the final follow-up (at mean 27.3 weeks), no significant difference was observed for total active motion of the digits and grip strength, when compared to the contralateral hand. Complete union was achieved in all fractures without deformity, or complications such as infection or nerve injury. All patients were satisfied with the cosmetic and functional outcomes.
Conclusion
K-wire stapling is an effective alternative modality in treating unstable displaced metacarpal neck or base fractures. It requires minimal incision to enable open reduction. In addition, early mobilization is ensured through the rigid fixations. Moreover, it prevents postoperative joint stiffness and reduces the time needed for treatment.

Keyword

Metacarpal fracture; Neck; Base; Staple; Open reduction
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