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Treatment of 5th Metacarpal Neck Fracture Using Percutaneous Transverse Fixation with K-Wires
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Jae Hak Jung, Kwan Hee Lee, Yong Ju Kim, Woo Jin Lee, Sung Hyun Choi
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J Korean Fract Soc 2012;25(4):317-322. Published online October 31, 2012
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DOI: https://doi.org/10.12671/jkfs.2012.25.4.317
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 Abstract
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- PURPOSE
To evaluate the radiologic and clinical results of percutaneous transverse fixation with K-wires for 5th metacarpal neck fracture.
MATERIALS AND METHODS
Between January 2007 and September 2010, 18 patients with a 5th metacarpal neck fracture, who underwent operative treatment, were included in this study. The surgical method was percutaneous transverse fixation using K-wires. We evaluated fracture angulation in oblique radiographs preoperatively, postoperatively, and at final follow-up, and used SPSS to perform statistical analysis. We also performed clinical evaluation using the Disabilities of the Arm, Shoulder and Hand (DASH) score.
RESULTS
All of the 18 cases were completely united, and in the oblique radiographs, the angulation was corrected from 50.69degrees to 11.68degrees. The average difference between postoperative and final follow-up angulations was 0.14degrees, which was statistically insignificant. Clinically, the DASH score was 1.030 and no complications were observed.
CONCLUSION
Percutaneous transverse fixation using K-wires could be one of the best ways to treat a 5th metacarpal neck fracture because of its simple method and low rate of complications.
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Flexible Intramedullary Nailing in Children's Femoral Shaft Fractures
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Yeo Hon Yun, Chang Ho Choi, Jae Hak Jung
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J Korean Soc Fract 2003;16(3):385-391. Published online July 31, 2003
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DOI: https://doi.org/10.12671/jksf.2003.16.3.385
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Abstract
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- PURPOSE
We report a treatment result and the pros-cons of the flexible intramedullary nailing for femoral shaft fractures in children between the ages of 4 and 11 years.
MATERIALS AND METHODS
During the recent three years, 28 femoral shaft fractures in 27 consecutive pediatric patients were treated with flexible intramedullary nailing. We retrospectively reviewed their clinical and radiological records, followed-up for at least one year, in respects to the recovery of knee joint motion; time of weight bearing; time of fracture union; period of admission and rehabilitation; angular deformity and leg length discrepancy; and other complications.
RESULTS
In all children, the knee joint motion was rapidly recovered to near normal range within 2~4 weeks. Partial weight bearing with wearing functional brace was possible within 2~4 weeks, while full weight bearing without brace was started until 6~12 (average 8.4) weeks after the nailing. In the last follow-up radiographs, five cases (18%) showed an angular deformity in any direction of more than 5 degrees. Two children represented leg length discrepancy of more than 1 cm. Other complications were one fixation failure, and one deep soft tissue infection at the entry point of the nail.
CONCLUSION
We strongly recommend the flexible intramedullary nailing in this injury because the fixation is strong enough to permit early knee motion and weight bearing in orthosis, the fracture healing was so rapid without any case of delayed or nonunion, and the incidences of residual angular deformity and leg length discrepancy were significantly less than the nonoperative treatment.
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Citations
Citations to this article as recorded by  - Comparison of Flexible Intramedullary Nailing with External Fixation in Pediatric Femoral Shaft Fractures
Do-Young Kim, Sung-Ryong Shin, Un-Seob Jeong, Yong-Wook Park, Sang-Soo Lee, Keun-Min Park
The Journal of the Korean Orthopaedic Association.2008; 43(1): 30. CrossRef
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Stability and Usefulness of Compression Hip Screw in the Treatment of Femur Intertrochanter Fracture in the Elderly
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Jong Oh Kim, Kwon Jae Roh, Yeo Heon Yun, Young Do Koh, Jae Doo Yoo, Jun Mo Jung, Han Cheon Bang, Jae Hak Jung
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J Korean Soc Fract 2003;16(2):128-135. Published online April 30, 2003
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DOI: https://doi.org/10.12671/jksf.2003.16.2.128
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Abstract
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- PURPOSE
To evaluate the relationship between fracture stability and functional results, and analyze the correlation between stability factors and the outcome in intertrochanteric fractures of the elderly.
MATERIALS AND METHODS
Of the 231 patients, 84 patients with age above 60 were able to follow up for minimum 6 months. We measured the sliding length of the lag screw, varus degree, position of lag screw, reduction status and medialization of distal fragment radiologically. The functional outcome of the treatment was evaluated with the Clawson's result classification and we evaluated the correlation between the radiological results of measurement and the functional recovery depending on the Evans fracture classification.
RESULTS
There were good results in 40 cases out of 51 stable fractures, and in 10 cases out of 33 unstable fractures (p<0.001). In case of sliding of lag screw more than 10 mm, good results were obtained in 4 cases, and poor in 21. And in case of sliding less than 10 mm, good results were obtained in 46, and poor in 13 (p<0.001). But there was no relationship between other radiologic factors and clinical results. In unstable type, there were 12 cases with lag screw sliding more than 10 mm and 10 cases with less than 10 mm. In comminuted type, there were 11 cases with lag screw sliding more than 10 mm and 2 cases with less than 10 mm (p<0.001).
CONCLUSION
The sliding of lag screw more than 10 mm may result in poor outcome. As in comminuted unstable pattern, sliding of lag screw might be excessive, the use of compression hip screw alone is not a good treatment option.
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