PURPOSE To evaluate radiological and clinical results of the antegrade intramedullary prebent K-wire fixation for the 5th metacarpal neck fracture. MATERIALS AND METHODS Between January, 2006 and December, 2009, 31 patients with displaced neck fracture of the fifth metacarpal who received antegrade intramedullary prebent K-wire fixation were included in this study. Radiological and clinical outcome evaluations were performed. RESULTS All the fractures were completely united. In the oblique radiographs, the average of preoperative angulation was corrected from 38.9degrees to 4.4degrees. The average difference between postoperative and final follow-up was 1.2degrees. Clinical outcomes were satisfactory except for one patient who had sustained ulnar nerve dorsal branch injury during surgery. CONCLUSION Antegrade intramedullary prebent K-wire fixation may be preferentially considered as one of the best ways to fix the displaced neck fractures of the fifth metacarpal.
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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 Journal of the Korean Fracture Society.2021; 34(1): 23. CrossRef
PURPOSE Although the standard treatment of diaphyseal forearm fractures in children is conservative treatment with closed reduction and cast immobilization, unstable or irreducible fractures are usually needed by surgical intervention. The aim of this article is to determine the efficacy of the percutaneous transphyseal intramedullary K-wires fixation for the forearm diaphyseal fractures in children. MATERIALS AND METHODS In this retrospective study, we reviewed 18 cases of forearm diaphyseal fractures in children, which were treated with percutaneous transphyseal intramedullary nailing using K-wires from January 2001 to December 2004. We analyzed the period for radiologic bone union and the complications until the last follow-up. RESULTS The average period of follow-up was 15 months with mean age of 7.8 years. The average time to bone union was 6.2 weeks and nonunion, malunion, radio-ulnar synostosis and refracture were not found, just 2 local pin site infections were seen but healed by conservative treatment. Postoperative scar was small and the complications until the last follow-up were not found. CONCLUSION In the operative treatment of the forearm diaphyseal fractures in children, we think percutaneous transphyseal intramedullary K-wire fixation is one of the effective methods because of the minimal invasiveness, simplicity and easiness in removal.
PURPOSE To evaluate indications and effectiveness of intramedullary K-wire fixation for distal radial fractures. MATERIALS AND METHODS Twenty one fractures of distal radius treated with intramedullary K-wire fixation from April 2001 to September 2002 were evaluated. The mean age was 67.8(range 46~82). Severely comminuted intra-articular fractures and Barton's fractures were excluded. One or two K-wires were added percutaneously. To assess the functional result, we used Green and O'Brien score system. The radiographic assessment included a scoring system based on measurements of radial length, radial inclination, volar tilt and step-off of the radial articular surface. RESULTS Average follow up period was 13.5 months. In functional result, excellent and good result were obtained in 18 cases (86%). In radiologic result, mean loss of radial length, radial inclination and volar tilt were 0.9 mm, 1.4degrees, 0.9degrees, respectively. CONCLUSION The advantages of intramedullary K-wire fixation were relatively simple procedure, low occurrence of soft tissue complications and early wrist motion. Intramedullary K-wire fixation was good to maintaining reduction in osteoporotic bone.
The metacarpal shaft fracture has been reported as a stable fracture relatively, but operative treatment is indicated when there happens reduction loss, or is in need of early exercise. Intramedullary K-wire fixation has been used for unstable transverse or long oblique diaphyseal fracture of the metacarpal bone. The fracture site is not opened and the K-wires are introduced under X-ray control. The techniques can stablize the fracture site and allow immediate exercise postoperatively.
We experienced 9 cases of 4th metacarpal shaft fracture treated by percutaneous intramedullary K-wire frxation with modified technique. The K-wire was used one or two ezch metacarpal fracture. The types of fracture were 4cases of transverse, 3 of oblique, 2 of comminuted. The average clinical union period were 5 weeks. There were not severe complications in all cases.
The fifth metacarpal neck fractures are unstable and often heals with angulation and deformity. So, after closed reduction and immobilization with splint or cast, they have often been lost reduction and healed with posterior angulation and cosmetic deformity. We conducted a prospective study of 11 patients who underwent percutaneous retrograde intramedullay K-wire fixation for a fracture of the neck of the fifth metacarpal during four years period.
We used a closed reduction technique derived from Jahss maneuver or three point fixation maneuver. And, the fracture was maintained with two cross or parallel smooth intramedullary K-wire. The proximal side of K-wire was placed back wound side near the wrist joint. The last follow up (postoperative 14±2 weeks) radiographic results were dorsal angualtion 7±4 , corresponded to preoperative 48±7 , and immediately postoperative 6±4 The complications such as limitation of movement, increase of dorsal angulation, rotational malalignment, shortening, and depression of the head of metacarpal were not occurred. Rotational deformity was always well controlled. Correction of angulation was good and K-wire insertion and fixation technique were easy. We recommend this technique in case of over 40 dorsal angulation of fracture site due to absence of contact between the palmar fractured ends, and patients who dont accept the cosmetic deformity or want early exercise.
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Comparative Evaluation of the Efficacy of Combined Intramedullary Pinning with K-Wires Pinning in the Treatment of Fifth Metacarpal Neck Fractures versus Conventional Techniques—K-Wires Pinning and Intramedullary Pinning Dong-Eun Kim, Tong-Joo Lee, Yeop Na, Ye-Geon Noh Medicina.2023; 59(11): 1944. CrossRef
Modified Bouquet Technique for Treatment of Metacarpal Neck Fractures Yong-Gyu Sung, Seok-Whan Song, Yoon-Min Lee Journal of the Korean Society for Surgery of the Hand.2016; 21(3): 137. CrossRef
Treatment of 5th Metacarpal Neck Fracture Using Percutaneous Transverse Fixation with K-Wires Jae-Hak Jung, Kwan-Hee Lee, Yong-Ju Kim, Woo-Jin Lee, Sung-Hyun Choi Journal of the Korean Fracture Society.2012; 25(4): 317. CrossRef
Treatment of Metacarpal Fractures using Transverse Kirschner-wire Fixation Nam Yong Choi, Hyun Seok Song The Journal of the Korean Orthopaedic Association.2007; 42(5): 608. CrossRef
Bouquet Pin Intramedullary Nail Technique of the 5th Metacarpal Neck Fractures Myung-Ho Kim, Moon-Jib Yoo, Jong-Pil Kim, Ju-Hong Lee, Jin-Won Lee Journal of the Korean Fracture Society.2007; 20(1): 64. CrossRef