Journal of Musculoskeletal Trauma

Minimal Invasive Fixation Methods for the Metacarpal Fracture: Ki Youn Kwon, Jin Rok Oh, Ji Woong Kwak; J Korean Fract Soc 2022;35(1):9-15. Published online January 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.1.9

Abstract PDF: Purpose
This study compared the radiologic and clinical outcomes of metacarpal fractures treated with two minimally invasive surgical techniques: Kirschner wire (K-wire) fixation and headless screw fixation.
Materials and Methods
This study included 52 patients (46 males and 6 females; age 18-55 years) with distal metacarpal fractures (middle and distal shaft, including the neck) who had undergone K-wire fixation or headless screw fixation. All subjects were followed up for at least six months. The radiologic assessments were performed to evaluate the angular deformity and shortenings. The total active motion (TAM), grip strength, and patients’ subjective functional assessment were measured to evaluate the hand function. The time taken to return to work (RTW) and adverse events were analyzed.
Results
Of the 52 cases, metacarpal fractures treated with headless screw fixation and K-wire fixation showed a significant difference associated with early RTW (p<0.05). There were no significant differences between the subjects treated with K-wire fixation and those with headless screw fixation in terms of the radiologic measurement, hand function examinations, complications, and adverse events (p>0.05).
Conclusion
After a six-month follow-up, minimally invasive K-wire fixation and headless screw fixation produced similar clinical and radiologic outcomes in subjects with metacarpal fractures. Compared to K-wire fixation, however, headless screw fixation led to earlier functional recovery and might be a better option for treating metacarpal fractures in this regard.

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Use of a Distraction Dynamic External Fixator in the Treatment of Comminuted Middle Phalanx Base Fractures: Sang Woo Kim, Chae Chil Lee, Sang Hun Ko, Il Yeong Hwang, Min Seok Kim, Woo Young Jin; J Korean Fract Soc 2019;32(1):1-5. Published online January 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.1.1

PURPOSE
This paper suggests the use of distraction dynamic external fixators (DDEF) for the treatment of proximal middle phalanx fractures.
MATERIALS AND METHODS
Seven patients, who were diagnosed with comminuted intra-articular fractures at the base of the middle phalanx from February 2014 to November 2016, were enrolled in this study (volar aspect 6 cases, dorsal aspect 1 case). They underwent a closed reduction under a C-arm image intensifier, and DDEF was applied with general anesthesia. Range of motion (ROM) exercise was encouraged after 3 to 5 days postoperatively, and DDEF was removed after 5 weeks. Subluxation, angulation and displacement were evaluated 6 weeks postoperatively.
RESULTS
The patients who were treated with DDEF showed a normal proximal interphalangeal joint ROM (100Â°), and there was no subluxation or displacement on the X-ray film 6 weeks postoperatively. In addition, there were no signs of infection, such as local heat, redness, and pus-like discharge.
CONCLUSION
DDEF helps maintain the reduction and reducing forces through the ligamentotaxis. The joint stiffness is reduced, which it makes early return to daily life easier.

Citations

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Treatment of Neglected Proximal Interphalangeal Fracture Dislocation Using a Traction Device: A Case Report
Yongun Cho, Jai Hyung Park, Se-Jin Park, Ingyu Lee, Eugene Kim
Journal of the Korean Fracture Society.2019; 32(4): 222. CrossRef

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Removal of a Broken Intramedullary Nail with a Narrow Hollow Using a Bulb-tipped Guide Wire and Kirschner Wire: A Case Report: Moses Lee, Kyu Hyun Yang; J Korean Fract Soc 2010;23(4):377-381. Published online October 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.4.377

Abstract PDF

To report the unusual failure of proximal femoral nail antirotation (PFNA) at the level of lag screw hole and introduce a simple technique for removal of a broken intramedullary nail with a narrow hollow using a bulb-tipped guide wire and Kirschner wire.

Citations

Citations to this article as recorded by

Novel Method for Removal of Broken Intramedullary Interlocking Nail with a Subtrochanteric Fracture
Ashwani Soni, Anmol Sharma, Rajeev Kumar Kansay, Deepam Vashist
JBJS Case Connector.2019; 9(4): e0182. CrossRef
METHOD FOR REMOVING BROKEN PROXIMAL FEMORAL NAILS USING EXISTING SCREW HOLE
CHO HONG MAN, MIN WOONG BAE
Acta Ortopédica Brasileira.2018; 26(1): 72. CrossRef
A blocking-wire technique for removal of a broken hollow intramedullary nail
Xuan-Lin Zheng, Young-Chang Park, Dong-Hyun Kang, Sang-Ok Seok, Yeo-Kwon Yoon, Kyu-Hyun Yang
Injury.2016; 47(7): 1601. CrossRef
Removal Methods for Broken Proximal Femoral Nails Using Ball Tip Guide Wire: Technical Note and Two Cases Report
Bong-Ju Park, Hong-Man Cho
Journal of the Korean Fracture Society.2014; 27(4): 315. CrossRef

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Intramedullary Fixation in the Fracture of the Shaft of the Clavicle by Threaded Kirschner Wire: Jae Kwang Yum, Se Jin Park; J Korean Fract Soc 2005;18(2):89-92. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.89

Abstract PDF: PURPOSE
To evaluate and report the clinical result of the intramedullary fixation by threaded Kirschner wire in the clavicle shaft fracture.
MATERIALS AND METHODS
From May 2000 to April 2004, twenty patients who had the fracture of the shaft of the clavicle were treated by the intramedullary fixation with threaded Kirschner wire. Thirteen patients were followed up and the clinical and radiological results were analyzed.
RESULTS
All of the cases had satisfactory fracture union but there were four cases of skin irritation signs by the tip of threaded Kirschner wire. In one case, the Kirschner wire was bent at the fracture site with malunion. According to the clinical scoring system of Kang et al, eight cases were excellent and five cases were good.
CONCLUSION
Authors think that intramedullary fixation with threaded Kirschner wire in the fracture of the shaft of the clavicle is one of a good operative method because of small operative incision, easy operative method, satisfactory fracture union and easy removability of the implant.

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Operative Treatment of Metacarpal Shaft Fracture>: Comparision of Low-Profile Miniplating System and Kirschner Wire Fixation: Hyun Dae Shin, Kwang Jin Rhee, Kyung Cheon Kim, Ho Sup Song; J Korean Fract Soc 2005;18(2):105-109. Published online April 30, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.2.105

Abstract PDF: PURPOSE
To compare Kirschner wire fixation and low profile miniplating system in metacarpal shaft fracture.
MATERIALS AND METHODS
Patients, available at least 1 year, who received the operative treatment after being diagnosed as metacarpal shaft fracture from 1997 May to 2003 May were the subjects with the exclusion of thumb fracture and intraarticular metacarpal bone fracture and also cases involving Kirschner wire fixation on severe laceration or open fracture. On the last follow up total action motion (TAM) and plain radiographes was checked.
RESULTS
In 7 cases (38.9%) where closed reduction and Kirschner wire fixation were carried out, 8 cases (61.5%) where open reduction and Kirschner wire fixation were carried out and 24 cases (88.9%) where open reduction using miniplate and screw showed either excellent or good results on TAM. 5 cases of dorsal angulation occured in closed reduction and Kirschner wire fixation group and 4 cases of dorsal angulation in open reduction and Kirschner wire fixation group however no cases of dorsal angulation occured in open reduction and miniplate and screw fixation group, and in all cases no rotational deformity, complications through ulnar or radial angulation occured. Internal fixation was carried out on 2 cases of nonunion which had closed reduction and Kirschner wire fixation carried out, while the rest all showed bony union.
CONCLUSION
Selective use of low profile miniplate and screw fixation in the metacarpal shaft fracture is more effective than in cases of comminuted fracture which can not be achieved firm fixation by Kirschner wire fixation. Low profile miniplate and screw fixation can get more precise anatomical reduction and firm fixation so it allow early return to daily living activity and show low complication rate.

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Treatment of the Clavicle Lateral End Fracture by Kirschner wire and Wire fixation: Jin Woo Kwon, Seung Ho Shin, Won Ho Cho, Woo Se Lee, Ki Hwan Kim, Dong Hyun Kim, Chun Ho Kim; J Korean Soc Fract 2001;14(2):214-222. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.214

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the effectiveness of Kirschner wire and additional wire fixation in clavicle lateral end fractures.
MATERIALS AND METHODS
We reviewed 14 cases that were treated by Kirschner wire and wire fixation from January 1997 to May 1999 and followed up for more than 1 year. Average age was 42 years old(male 6, female 8). The fractures were classified according to Jager and Breitner classification : 2 cases of type 1, 5 of type 2a, 5 of type 2b, 2 of type 3. We used 3 types of fixation method : First, interfragment Kirschner wire and wire fixation in simple fracture. Second, first method was reinforced with transacromial Kirschner wire fixation in simple, but osteoporotic bone. Third, fracture was fixed by transacromial Kirschner wire and wire fixation in intraarticular or comminuted fracture.
RESULTS
Bony union was obtained in all cases with average duration of 10 weeks. The functional result of shoulder was evaluated by the scoring system of Rowe : exellent 8, good 5, fair 1 case. The complications were pin migration 2, pin infection 1, shoulder LOM 3, traumatic acromioclavicular joint arthritis 2 cases.
CONCLUSION
Appropriate use of three types of Kirschner wire and wire fixation technique according to location of fracture, degree of comminution can improve bony union rate and shoulder function.

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Aorto-Innominate Venous Fistula after percutaneous kirschner wire fixation of the Sternoclavivular Joint Anterior Dislocation: A case report: Choong Gil Lee, Jin Woo Kwon, Kyoung Tae Sohn, Seung Ho Shin, Jong Cheon Park; J Korean Soc Fract 1998;11(4):953-957. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.953

Abstract PDF: Kirschner wire fixation in sternoclavicular dislocation poses a considerable risk of serious early or late complications. We report a case of Kirschner wire penetration into the innominate vein and aorta, which caused aortovenous fistula and congestive heart failure.

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