Standing repair of an articular dorsal medial oblique fracture of the proximal third metacarpal bone in a racing Standardbred

2019 ◽  
Vol 32 (4) ◽  
Author(s):  
N. E. Lean ◽  
B. J. Ahern

1998 ◽  
Vol 11 (04) ◽  
pp. 200-204 ◽  
Author(s):  
K. Kelly ◽  
G. S. Martin ◽  
D. J. Burba ◽  
S. A. Sedrish ◽  
R. M. Moore

SummaryThe purpose of the study was to determine and to compare the in vitro pullout strength of 5.5 mm cortical versus 6.5 mm cancellous bone screws inserted in the diaphysis and metaphysis of foal third metacarpal (MCIII) bones in threaded 4.5 mm cortical bone screw insertion holes that were then overdrilled with a 4.5 mm drill bit. This information is relevant to the selection of a replacement screw if a 4.5 mm cortical screw is stripped during orthopaedic surgery. In vitro pullout tests were performed in two independent cadaver studies, each consisting of 12 foal MCIII bones. Two 4.5 mm cortical screws were placed either in the mid-diaphysis (study 1) or distal metaphysis (study 2) of MCIII bones. The holes were then overdrilled with a 4.5 mm bit and had either a 5.5 mm cortical or a 6.5 mm cancellous screw inserted; screw pullout tests were performed at a rate of 0.04 mm/s until screw or bone failure occurred.The bone failed in all of the tests in the diaphyseal and metaphyseal bone. The holding power for 6.5 mm cancellous screws was significantly (p <0.05) greater than for 5.5 mm cortical screws in both the diaphysis and metaphysis. There was not any difference in the holding power of screws in either the diaphysis or the metaphysis between proximal and distal screw holes.If a 4.5 mm cortical bone screw strips in MCIII diaphyseal or metaphyseal bone of foals, a 6.5 mm cancellous screw would provide greater holding power than a 5.5 mm cortical screw.In order to provide information regarding selection of a replacement screw if a 4.5 mm cortical screw is stripped, the in vitro pullout strength was determined for 5.5 mm cortical and 6.5 mm cancellous screws inserted in third metacarpal diaphyseal and metaphyseal bone of foals in which threaded 4.5 mm cortical bone screw insertion holes had been overdrilled with a 4.5 mm bit. The holding power of the 6.5 mm cancellous screw was significantly greater than the 5.5 mm cortical screw in both the diaphysis and metaphysis of foal third metacarpal bone. Thus, it appears that if a 4.5 mm cortical screw is stripped during orthopaedic surgery in foals, a 6.5 mm cancellous screw would provide superior holding power.



2020 ◽  
Author(s):  
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2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yung-Cheng Chiu ◽  
Tsung-Yu Ho ◽  
Yen-Nien Ting ◽  
Ming-Tzu Tsai ◽  
Heng-Li Huang ◽  
...  

Abstract Background Metacarpal shaft fracture is a common fracture in hand trauma injuries. Surgical intervention is indicated when fractures are unstable or involve considerable displacement. Current fixation options include Kirschner wire, bone plates, and intramedullary headless screws. Common complications include joint stiffness, tendon irritation, implant loosening, and cartilage damage. Objective We propose a modified fixation approach using headless compression screws to treat transverse or short-oblique metacarpal shaft fracture. Materials and methods We used a saw blade to model transverse metacarpal neck fractures in 28 fresh porcine metacarpals, which were then treated with the following four fixation methods: (1) locked plate with five locked bicortical screws (LP group), (2) regular plate with five bicortical screws (RP group), (3) two Kirschner wires (K group), and (4) a headless compression screw (HC group). In the HC group, we proposed a novel fixation model in which the screw trajectory was oblique to the long axis of the metacarpal bone. The entry point of the screw was in the dorsum of the metacarpal neck, and the exit point was in the volar cortex of the supracondylar region; thus, the screw did not damage the articular cartilage. The specimens were tested using a modified three-point bending test on a material testing system. The maximum fracture forces and stiffness values of the four fixation types were determined by observing the force–displacement curves. Finally, the Kruskal–Wallis test was adopted to process the data, and the exact Wilcoxon rank sum test with Bonferroni adjustment was performed to conduct paired comparisons among the groups. Results The maximum fracture forces (median ± interquartile range [IQR]) of the LP, RP, HC, and K groups were 173.0 ± 81.0, 156.0 ± 117.9, 60.4 ± 21.0, and 51.8 ± 60.7 N, respectively. In addition, the stiffness values (median ± IQR) of the LP, HC, RP, and K groups were 29.6 ± 3.0, 23.1 ± 5.2, 22.6 ± 2.8, and 14.7 ± 5.6 N/mm, respectively. Conclusion Headless compression screw fixation provides fixation strength similar to locked and regular plates for the fixation of metacarpal shaft fractures. The headless screw was inserted obliquely to the long axis of the metacarpal bone. The entry point of the screw was in the dorsum of the metacarpal neck, and the exit point was in the volar cortex of the supracondylar region; therefore the articular cartilage iatrogenic injury can be avoidable. This modified fixation method may prevent tendon irritation and joint cartilage violation caused by plating and intramedullary headless screw fixation.



2021 ◽  
Author(s):  
Ran Shan ◽  
Anna S. Johnston ◽  
Sarah M. Rosanowski ◽  
John O'Shea ◽  
Christopher M. Riggs


2018 ◽  
Vol 8 (1) ◽  
pp. 1323-1325
Author(s):  
Laila Mohamed Ilias ◽  
Babitha Alingal Mohammed ◽  
Roshini PS ◽  
Anupama Ponniah ◽  
Poornima Vijayan

Bizzare parosteal osteochondromatous proliferation, or Nora‘s lesion is a unique bone lesion that most often arises in the small bones of hands and feet.  It is characterised by proliferation of chondroid, bony and fibrous tissue, and is occasionally misdiagnosed as a malignant process.  Our case was a 31 yr old lady, who presented with a painless swelling near the 5th metacarpal bone of right hand.  X-ray showed well marginated mineralised mass arising from the cortical surface of the metacarpal bone.  Histopathological examination revealed bizarre parosteal osteochondromatous proliferation composed of varying amounts of cartilage, bone and spindle cells. Cartilage was hypercellular and chondrocytes were enlarged. Ossification was irregular and had a peculiar blue tinctorial quality. 







Hand Surgery ◽  
2001 ◽  
Vol 06 (02) ◽  
pp. 239-242 ◽  
Author(s):  
H. C. Chang ◽  
K. H. Lew ◽  
C. O. Low

Metastatic tumours of the hand are uncommon. The majority of these tumours affect the phalanges and the primary tumours are usually bronchogenic in origin, with breast and kidney tumours next in frequency. Metastatic gastrointestinal to the hand is rare and usually from the colon. We report a case of poorly differentiated adenocarcinoma of the stomach antrum presenting with a metastatic lesion to the right 4th metacarpal bone. A review of the literature is included.



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