Treatment of Metacarpal Shaft Fractures with Retrograde Intramedullary Kirschner-Wire Fixation

Moon,  Chan Sam; Jeon,  Ho Seung; Jeon,  Seung Ju; Seo,  Young Ray; Noh,  Haeng Kee

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Journal of the Korean Society for Surgery of the Hand 2010;15(1):1-7.
Published online March 1, 2010.

Treatment of Metacarpal Shaft Fractures with Retrograde Intramedullary Kirschner-Wire Fixation

Chan Sam Moon, Ho Seung Jeon, Seung Ju Jeon, Young Ray Seo, Haeng Kee Noh

Department of Orthopedic Surgery, Sung-Ae Hospital, Seoul, Korea. osnoh@korea.com

Abstract

Purpose
The purpose of this study is to evaluate the clinical results of retrograde intramedullary fixation of metacarpal shaft fractures using two pre-bent Kirschner wires. MATERIALS AND METHODS: Between March 2006 and May 2008, 19 cases (17 patients) of metacarpal shaft fractures were treated with the retrograde intramedullary Kirschner-wire fixation and followed at least one year. The exclusion criteria were thumb metacarpal fractures, comminuted fractures and irreducible metacarpal spiral shaft fracture by closed manipulation. At final follow up all the cases were assessed with total active motion(TAM), rotational deformity, bony union and angular deformity based on the plain radiographes.

Results
At the last follow-up, all cases achieved bony union. Five cases showed less than 5degrees of dorsal angular deformity. The average union period was 6.3 weeks (range, 5-9weeks). Fifteen cases (79%) showed excellent results, four cases good results based on TAM. No case showed rotational deformity. Two cases had skin irritation by distal wire end, which was subsided after wire removal.

Conclusions
In patients with a metacarpal shaft fracture, retrograde intramedullary fixation using two pre-bent K-wires can provide satisfactory clinical results.

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