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Journal of the Korean Society for Surgery of the Hand 2008;13(2):92-95.
Published online June 1, 2008.
Extensor Mechanism Injury by Retrograde Intramedullary, K-wire Fixation of Metacarpal Neck Fractures
Soo-Hong Han,Hyung-Ku Yoon,Byung-Ho Yoon,Tae-Keun Ahn
중수골 경부 골절 시 역행성 골수강 내 핀 고정술과 신전 기능의 손상
Introduction: The vast majority of metacarpal neck fractures are stable and treated conservatively. Nevertheless, surgical treatment is justified in certain cases like unstable, displaced fractures. When surgical intervention is necessary, retrograde intramedullary pin fixation is one of commonly used fixation methods for treatment. Even though pin penetrates extensor tendon during fixation procedure, study about extensor mechanism change after this fixation is very rare. Authors evaluated results of intramedullary K-wire fixation for metacarpal fractures and analyzed damage to the extensor mechanism. Materials & Methods: A retrospective analysis of 60 patients who had retrograde intramedullary K-wire fixation for metacarpal neck fractures was performed. Mean age was 24.1 years old and average follow up period was 1 year 11 months. Open injury, severe communition and multiple freatures are excluded in this study Radiographic frature healing, size of K-wires, range of motion at the last follow up and complications were evaluated during follow up. Results: Forty three (72%) patients had fractures at the 5th metacarpal neck. Bone union, angulation correction were achieved in all cases and average union time was 5 weeks 4 days postoperatively. 1.6 mm diameter K-wire was most commonly used in 46 cases (77%), but there was no statistical differences in results between K-wire sizes. Only One patient showed ROM limitation of 20 degree extension lag at the last follow up due to insufficient rehabilitation and other complication was temporary superficial infection in one case. Conclusion: Retrograde intramedullary K-wire fixation is a minimally invasive method for stabilizing metacarpal fractures and showed excellent results in our study. Damage to extensor mechanism was minimal and it is not necessary to restrict indication to avoid extensor mechanism injury.

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