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Journal of the Korean Society for Surgery of the Hand 2004;9(3):117-122.
Published online September 1, 2004.
Treatment method of the Metacarpal Bone Fractures with Retrograde Percutaneous Intramedullary K-wire Fixation to Decrease the Injury of Extensor Tendon
Soo-Joong Choi, Sung-Keun Chang
중수골 골절에서 신전건 손상을 줄이는 역행적 경피성 골수강내 K-강선 고정법
최수중, 장성근
This study is how to decrease the injury of the extensor tendon in percutaneous intramedullary fixation with K-wire for metacarpal bone fractures. Materials and Methods: Study of 14 cases with shaft or neck fractures of the 4th metacarpal bone was done, in which the patients were treated with K-wire for fixation and reduction of fractured bone with retrograde percutaneous intramedullary fixation approach between January, 1, 1997 and December, 31, 2002. Large sized (0.062 inch) one K-wire was inserted percutaneously to the head of metacarpal bone. In fixation of fracture of the 4th metacarpal bone, we made a small skin incision for identification and retraction of extensor tendon. We started ROM exercise of metacarpophalangeal joint from the next day after the operation. Results: All the fractures were completely united until 8 weeks (average 5 weeks) after the operation radiographically. Mean angular deformity was 1.3¡Æ, ranged from 0¡Æto 3¡Æ, no rotational deformity on the radiographs when compared with opposite side, and there was no limitation of motion of wrist and metacarpophalangeal joint at final follow-up. Conclusion: The result suggested that percutaneous intramedullary fixation with one K-wire at the level of metacarpophalangeal joint and identification and retraction of extensor tendon are the effective methods for the metacarpal neck or shaft fractures without limitation of motion of metacarpophalangeal joints and extensor tendon injury.

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