Journal of Musculoskeletal Trauma

Clinical Outcomes of Customized Staple Fixation Using K-wire in Metacarpal Base or Neck Fractures: Hong-ki Jin, Hyoung Min Kim, Yong Seung Oh, Jihoon Kim; J Korean Fract Soc 2021;34(1):23-29. Published online January 31, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.1.23

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.

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Individualized herbal prescriptions for delayed union: A case series
Jiyoon Won, Youngjin Choi, Lyang Sook Yoon, Jun-Hwan Lee, Keunsun Choi, Hyangsook Lee
EXPLORE.2023; 19(2): 260. CrossRef

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Comparison of Early Fixation and Late Fusion of 4, 5th Carpometacarpal Joint in the Intra-Articular Fractures of 4th and 5th Metacarpal Base: Chang Ho Yi, Jin Rok Oh; J Korean Fract Soc 2011;24(1):60-66. Published online January 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.1.60

Abstract PDF

PURPOSE
To evaluate clinical results between early fixation group and delayed fusion group in treatment of intraarticular fracture of 4th, 5th metacarpal base.
MATERIALS AND METHODS
From March 2002 to December 2006, 21 cases of early fusion and 11 cases of delayed fusion of 4, 5th carpometacarpal joint were reviewed retrospectively or were included in this study. Average follow up period is 39.9 months. Bony union was checked by plain films at follow up. DASH-questionnaire, VAS pain scale, grip power and range of motion of 4th, 5th metacarpophalangeal joint were also checked at last follow up.
RESULTS
In radiologic study, bony union was confirmed in all cases of two groups. Early fixation group showed better outcomes than delayed fusion group in range of motion, DASH-questionnaire and VAS pain scale with statistical significant (p<0.004).
CONCLUSION
Because early fixation group showed better clinical outcomes than delayed fusion group, early diagnosis and proper surgical treatment are important for better outcomes in treatment of intraarticular fracture of 4th, 5th metacarpal base.

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Fourth and Fifth Metacarpal Base Arthrodesis for Posttraumatic Arthritis of Fifth Carpometacarpal Joint
Chul-Hyung Kang, Eun-Sok Son, Chul-Hyun Cho
Journal of the Korean Society for Surgery of the Hand.2013; 18(4): 184. CrossRef

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Displaced fracture of the base of the second metacarpal into velar side: Yerl Bo Sung, Sung Soo Kim; J Korean Soc Fract 1997;10(4):945-948. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.945

Abstract PDF: Fracture of the base of the second metacarpal bone is usually undisplaced or minimallly displaced. There were some reports of traumatic avulsion fracture of the extensor carpi radialis longus from the base of the second metacarpal. In most cases, the fragments were displaced into dorsal side However, there is noreport uf displaced fracture of the base of the second metacarpal into volar side in English papers. We are reporting a case in which the fragment was displaced into volar side.

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