THUMB METACARPOPHALANGEAL ARTHRODESIS WITH LOCAL BONE GRAFTING

Hand Surgery ◽  
2011 ◽  
Vol 16 (01) ◽  
pp. 55-61 ◽  
Author(s):  
Rebel Huffman ◽  
Ghazi M. Rayan
Keyword(s):  
Pain Relief ◽  
Bone Graft ◽  
Kirschner Wire ◽  
Union Rate ◽  
Effective Technique ◽  
Kirschner Wire Fixation ◽  
Local Bone ◽  
Wire Fixation ◽  
Contralateral Hand

A restrospective study identified 47 thumb MP joints in 41 patients who underwent arthrodeses using cup and cone osteotomy secured with Kirschner-wire fixation and augmented with local bone graft from the thumb metacarpal. Union rate was 96% averaging 6.8 weeks. Two patients had nonunion; 6.3 year follow-up of 15 thumbs showed improvement of or no pain. MHQ scores were 56.5 in the operative hand and 66.7 in the contralateral hand. Thumb MP arthrodesis augmented with local bone graft negates the morbidity of obtaining distant graft. It is a safe and effective technique that provides excellent pain relief with an acceptable union rate.

scholarly journals Closed reduction and percutaneous k-wire fixation for distal end radius fractures

2020 ◽  
Vol 8 (7) ◽  
pp. 2400
Author(s):  
Tanveer Ali ◽  
Mohmmad Sikander Baketh ◽  
Maneer Ahmad Mir
Keyword(s):  
Functional Outcome ◽  
Distal Radius ◽  
Kirschner Wire ◽  
Mayo Score ◽  
Kirschner Wire Fixation ◽  
Anatomic Reduction ◽  
Wire Fixation ◽  
Inexpensive Procedure ◽  
Anatomical Restoration

Background: To evaluate radiological and functional outcome in fractures of the distal radius treated by K-wire fixation.Methods: Forty patients (16 males, 24 females) with different types of fractures of distal radius were treated. K-wire fixation was performed under axillary bolock or general anaesthesia. Anatomical  restoration was evaluated by postero-anterior and lateral radiographs obtained preoperatively and at 09 months of follow up to evaluate Radial Height (RH), Radial Inclination (RI) and Volar Tilt (VT). Functional outcome was evaluated using Mayo scoring system.Results: According to Mayo score 72.5% (n=29) of our patients had excellent to good outcome while as 17.5% (n=7) had fair outcome and 10% (n=4) patients had poor outcome.Conclusions: Kirschner wire fixation is an inexpensive procedure that  provides anatomic  reduction,  fracture  fixation,  and maintenance  of  reduction  with  an  adequate method of  immobilization.

Arthrodesis of the Interphalangeal Joint of the Hallux

2001 ◽  
Vol 91 (8) ◽  
pp. 427-434 ◽  
Author(s):  
Gerard V. Yu ◽  
Frank E. Vargo ◽  
Joel W. Brook
Keyword(s):  
Simple Technique ◽  
Functional Unit ◽  
Screw Fixation ◽  
Kirschner Wire ◽  
Interphalangeal Joint ◽  
Kirschner Wires ◽  
Effective Technique ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Common Problems

The authors present a simple and effective technique to achieve arthrodesis of the hallucal interphalangeal joint. Stabilization is achieved by external fixation with crossing Kirschner wires joined together to create a single functional unit, a technique that avoids common problems often associated with Kirschner-wire fixation. The authors propose that this simple technique be considered for patients in whom it has been determined that screw fixation should not be used to obtain fusion of the interphalangeal joint. (J Am Podiatr Med Assoc 91(8): 427-434, 2001)

Treatment of nonunions of the distal phalanx with olecranon bone graft

2009 ◽  
Vol 34 (5) ◽  
pp. 638-642 ◽  
Author(s):  
İ. B. ÖZÇELIK ◽  
F. KABAKAS ◽  
B. MERSA ◽  
H. PURISA ◽  
İ. SEZER ◽  
...  
Keyword(s):  
Bone Graft ◽  
Donor Site ◽  
Kirschner Wire ◽  
Distal Phalanx ◽  
Kirschner Wire Fixation ◽  
Clinical Pain ◽  
Initial Injury ◽  
Phalangeal Fractures ◽  
Radiological Union

Distal phalangeal fractures are the most common fractures of the hand but nonunions are unusual in the distal phalanx. Eleven patients were operated on for nonunions of the distal phalanx. The diagnosis of nonunion was made by the presence of the clinical (pain, deformity, instability) and radiological signs of nonunion more than 4 months after the initial injury. Three patients had developed infection and four of them had bone resorption after their initial treatments, which probably caused nonunion. Olecranon bone grafting combined with Kirschner wire fixation was done in all patients. The mean follow up was 7 months (range 5–18 months). There were no major complications at the donor or recipient sites. One patient had a haematoma formation at the donor site. There was complete radiological union of bone-grafted sites in all patients except one. There were no cases of pain, deformity, or instability after the treatment. The olecranon bone graft was found to be safe and easy to harvest. Its strong tubular structure replaced the distal phalanx successfully.

The Treatment of Dorsal Fracture-Dislocation of the Proximal Interphalangeal Joint by Closed Reduction and Kirschner Wire Fixation: A 16-Year Follow Up

2001 ◽  
Vol 26 (6) ◽  
pp. 537-540 ◽  
Author(s):  
D. P. NEWINGTON ◽  
T. R. C. DAVIS ◽  
N. J. BARTON
Keyword(s):  
Closed Reduction ◽  
Articular Surface ◽  
Kirschner Wire ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Long Term Results ◽  
Kirschner Wire Fixation ◽  
Wire Fixation

Ten patients who had sustained 11 unstable dorsal fracture-dislocations of finger proximal interphalangeal joints were reviewed at a mean follow-up of 16 years. All had been treated acutely by closed reduction and transarticular Kirschner wire fixation of the proximal interphalangeal joint, without any attempt at reduction of the fracture of the base of the middle phalanx, which probably involved 30–60% of the articular surface. Seven of the ten patients complained of no finger pain or stiffness, and none complained of severe pain. There was a mean fixed flexion deformity of 81 at the proximal interphalangeal joint, which had a mean arc of movement of 851. Although subchondral sclerosis and mild joint space narrowing were observed in some instances, there were no severe degenerative changes. These results confirm that this technique is a reliable treatment method for these injuries, and produces satisfactory long-term results.

HEMI-HAMATE ARTHROPLASTY VERSUS TRANSARTICULAR KIRSCHNER WIRE FIXATION FOR UNSTABLE DORSAL FRACTURE-DISLOCATION OF THE PROXIMAL INTERPHALANGEAL JOINT IN THE HAND

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 115-119 ◽  
Author(s):  
R. C. Barksfield ◽  
B. Bowden ◽  
A. J. Chojnowski
Keyword(s):  
Bone Grafting ◽  
Kirschner Wire ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Fracture Dislocations ◽  
Fixed Flexion Deformity

Following the introduction of the hemi-hamate arthroplasty (HHA) technique to our unit, we sought to evaluate the early clinical outcomes achieved with this method of fixation and compare these with simple trans-articular Kirschner wire (K-wire) fixation for dorsal fracture dislocations (DFD) of the proximal interphalangeal joint (PIPJ). Ninteen patients underwent fixation of these injuries with either K-wire fixation (12/19) or hemi-hamate bone grafting (7/19) between 2005 and 2011. At a mean follow-up of 14 weeks median arc of movement at the PIPJ was 65° (range 31° to 108°) following HHA and 56° (range 9° to 85°) (p = 0.82) following temporary transarticular K-wire fixation. Median fixed flexion deformity (FFD) was 20° and 15° for hemi-hamate bone grafting and K-wire fixation respectively. Based upon our findings, transarticular K-wire fixation produced equivalent outcomes to HHA for unstable DFD of the PIPJ in the hand.

scholarly journals UNSTABLE FRACTURE OF RADIUS AND ULNA

2011 ◽  
Vol 18 (02) ◽  
pp. 323-327
Author(s):  
WAQAR ALAM ◽  
FAAIZ ALI SHAH ◽  
ZAFAR DURRANI ◽  
Zahid Askar ◽  
Muhammad Ayaz Khan ◽  
...  
Keyword(s):  
Kirschner Wire ◽  
Unstable Fracture ◽  
Fractures In Children ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Ulna Fractures ◽  
K Wires ◽  
Age Range ◽  
Radiological Union

Objectives: To know the functional outcome of Intramedullary Kirschner Wire fixation of unstable Radius-Ulna fractures in children. Study Design: Descriptive study. Period: 27/03/2009 to 26/03/2010. Setting: Department of Orthopedic and Trauma, Khyber Teaching Hospital, Peshawar. Patients and Methods: All patients were admitted from OPD . Children less than 16 years with Unstable Radius- Ulna fractures were included in the study. Patients with open fractures and adults with polytrauma were excluded from the study. Unstable Radius-Ulna fractures were treated by Intramedullary Kirschner Wire fixation under general anesthesia and tourniquet control. Follow up till radiological and clinical union was done. K-wires were removed after healing of fractures. Patients were assessed functionally and radiologically and results were graded according to Price et al Criteria. Results: A total of 64 children with unstable radius and ulna fractures were included in the study. The age range was 6 to 15 years with average age of 10.41 years. 47 were male and 17 were female. The average time of radiological union was 7 weeks and K-wires were removed at 8 weeks time. At final assessment there were 47 Excellent, 10 Good and 7 Fair results. Conclusions: Excellent results can be achieved by Intramedullary K-Wires fixation. In children with unstable Radius-Ulna fractures. It should be the method of choice for treating these fractures.

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