scholarly journals A novel method for internal fixation of basal fifth metatarsal fracture in athletes: a cadaveric study of the F.E.R.I. technique (Fifth metatarsal, Extra-portal, Rigid, Innovative)

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Pieter D’Hooghe ◽  
Silvio Caravelli ◽  
Simone Massimi ◽  
James Calder ◽  
Peter Dzendrowskyj ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Stress Test ◽  
Kirschner Wire ◽  
Cadaveric Study ◽  
Return To Play ◽  
Non Union ◽  
Kirschner Wire Fixation ◽  
Satisfactory Outcome ◽  
Novel Method ◽  
Intramedullary Screw

Abstract Purpose One of the main problems of Kirschner wire fixation of fifth metatarsal base fractures (in combination with a tension band wiring technique) seems to be hardware intolerance and several studies in athletes also report failure after isolated fixation with a screw only. These reports prompted us to look at new materials and a novel technique through fixation with an intramedullary screw combined with a high-resistance suture via the presented F.E.R.I. (Fifth metatarsal, Extra-portal, Rigid, Innovative) technique. Methods This cadaveric study describes F.E.R.I. technique. On a cadaver, through two mini portals, a full reduction and solid internal fixation with an intramedullary screw and suture cerclage with Fiberwire of a fifth metatarsal base fracture is achieved. In this article, the cadaveric study and proposed surgical technique are explained and illustrated step by step. Results The presented internal fixation F.E.R.I. technique is indicated in acute proximal fractures, stress fractures or non-union of metatarsal 5 (Zone 2–3 by Lawrence and Botte) and it resulted feasible and stable during manual stress test. The authors intend to study this technique in the clinical setting in the near future. Conclusions Fifth metatarsal base fractures gain specific interest when occurring in athletes. In this group of patients, internal fixation is often required to obtain a satisfactory outcome and time to return to play. The aim of the presented cadaveric study is to illustrate an innovative concept of internal fixation, named F.E.R.I.

INTERNAL FIXATION WITH THE LOW PROFILE PLATE SYSTEM COMPARED WITH KIRSCHNER WIRE FIXATION: CLINICAL RESULTS OF TREATMENT FOR METACARPAL AND PHALANGEAL FRACTURES

Hand Surgery ◽  
2010 ◽  
Vol 15 (01) ◽  
pp. 1-6 ◽  
Author(s):  
Hidetake Takigami ◽  
Hiroaki Sakano ◽  
Tomoyuki Saito
Keyword(s):  
Kirschner Wire ◽  
Clinical Results ◽  
Delayed Union ◽  
Non Union ◽  
Results Of Treatment ◽  
Kirschner Wire Fixation ◽  
Active Flexion ◽  
Low Profile ◽  
Screw Breakage ◽  
Phalangeal Fractures

A total of 71 patients with 78 metacarpal or phalangeal fractures were treated using one of two different methods of fixation. Thirty-nine fingers were treated using a low profile plate and screw system (LPP group), whereas 39 fingers were treated using Kirschner wire (K-wire group). In the LPP group, three cases of screw breakage were recorded. The LPP group required use of a splint for 0.9 weeks, significantly less than the 4.4 weeks of the K-wire group. The mean of 2.6 ± 1.6 months for the time to union in the LPP group was significantly greater than the 1.6 ± 0.6 months in the K-wire group. There were no instances of non-union in both groups, but one delayed union was observed in the LPP group. Total active flexion was 235° and 243° in the LPP and the K-wire groups, respectively. Total extension loss was 12° and 9° in the LPP and the K-wire groups, respectively. Although use of either method resulted in a good range of motion, LPP fixation required a much shorter time with a splint. However, because of the possibility of screw breakage, we have to exercise caution with post-operative treatment.

Non-Union in a Fracture of the Shaft of the Distal Phalanx

HAND ◽  
1982 ◽  
Vol os-14 (1) ◽  
pp. 85-88 ◽  
Author(s):  
L. Read
Keyword(s):  
Open Reduction ◽  
Kirschner Wire ◽  
Middle Finger ◽  
Distal Phalanx ◽  
Non Union ◽  
Shaft Fractures ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Type Of Fracture

Fracture of the shaft of the distal phalanx is less common than more distal fractures involving the tuft: non-union in such a fracture is even more unusual. A case is described in which troublesome non-union of the shaft of the distal phalanx of the middle finger was successfully treated by open reduction and Kirschner wire fixation. The type of fracture and its treatment is discussed: it is emphasised that the principles applied to shaft fractures of the middle and proximal phalanges also apply to the distal phalanx.

An Uncommon Presentation of Fracture-dislocation of the 4th and 5th Carpometacarpal Joints with Volar Displacement and its Management

2021 ◽  
Vol 11 (9) ◽  
Author(s):  
Nikhil Jawaharlal ◽  
Vasanthakumar Ramsingh ◽  
Vijaya Bhalaik
Keyword(s):  
Kirschner Wire ◽  
Fracture Dislocation ◽  
Carpometacarpal Joint ◽  
Carpometacarpal Joints ◽  
Kirschner Wire Fixation ◽  
Joint Fracture ◽  
Satisfactory Outcome ◽  
Uncommon Presentation ◽  
Fracture Dislocations ◽  
Poor Outcomes

Introduction: Carpo-metacarpal joint fracture-dislocations are rare injuries. They constitute less than 1% of all hand injuries [1]. They often go unnoticed [2]. Of these, dorsal fracture-dislocations on the ulnar side are more commonly seen [3] because of the greater stabilizing dorsal structures. Volar fracture-dislocations are very rare and difficult to diagnose for which, one should have a keen eye on. Case Report: This is a case of a 51-year-old female with a closed injury to her wrist. With clinical suspicion and appropriate radiographs fracture-dislocation of the 4th and 5th carpometacarpal joints with volar displacement was diagnosed. She underwent closed reduction and percutaneous Kirschner wire fixation, followed by 6 weeks of immobilization. At the final follow-up in 4 months, the patient was noted to have a satisfactory outcome following intense physiotherapy. Conclusion: Fourth and fifth carpometacarpal joint fracture-dislocations of the fingers are unique; their diagnosis can be challenging and often overlooked [4], which if missed can have very poor outcomes. The functional prognosis depends on the precocity of diagnosis and appropriate reduction and vigorous rehabilitation. Keywords: Carpometacarpal joint, fracture-dislocation, volar displacement, wrist injury.

Open Reduction-Internal Fixation of a Navicular Body Fracture with Dorsal Displacement of the First and Second Cuneiforms

2013 ◽  
Vol 103 (3) ◽  
pp. 246-249 ◽  
Author(s):  
Robert C. Andersen ◽  
Katherine Neiderer ◽  
Billy Martin ◽  
James Dancho
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Revisional Surgery ◽  
Kirschner Wire ◽  
Open Reduction Internal Fixation ◽  
Kirschner Wire Fixation ◽  
Body Fracture ◽  
Wire Fixation ◽  
Ligamentous Reconstruction

Body fractures of the tarsal navicular are relatively uncommon. To date, there is little literature discussing a navicular body fracture with dorsal subluxation of the first and second cuneiforms over the navicular. This case study presents a 30-year-old patient with this injury. He underwent open reduction internal fixation of the navicular body fracture successfully but failed adequate reduction of the navicular cuneiform joint after ligamentous reconstruction. After revisional surgery, he also failed 6 weeks of percutanous pinning with Kirschner-wire fixation. When comparing the literature of a similar injury, the Lisfranc fracture disclocation, the same principles may apply. One should consider rigid open reduction internal fixation or even primary fusion to treat disclocation of the naviculocuneiform joint following a navicular body fracture. (J Am Podiatr Med Assoc 103(3): 246–249, 2013)

Open Reduction and Internal Fixation of Mandibular Angle Fractures Using Temporary Kirschner Wire Fixation

2012 ◽  
Vol 129 (1) ◽  
pp. 192e-194e ◽  
Author(s):  
Adam D. Perry ◽  
Derrick C. Wan ◽  
Hubert Shih ◽  
Neil Tanna ◽  
James P. Bradley
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Kirschner Wire ◽  
Mandibular Angle ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Angle Fractures

Dorsal Fracture–Dislocation of the Proximal Interphalangeal Joint: A Comparative Study of Percutaneous Kirschner Wire Fixation Versus Open Reduction and Internal Fixation

2005 ◽  
Vol 30 (2) ◽  
pp. 120-128 ◽  
Author(s):  
A. ALADIN ◽  
T. R. C. DAVIS
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Kirschner Wire ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Cerclage Wire ◽  
Kirschner Wire Fixation ◽  
Wire Fixation

Nineteen patients with a dorsal fracture–dislocation of the proximal interphalangeal joint of a finger were treated with either closed reduction and transarticular Kirschner wire fixation (eight cases) or open reduction and internal fixation, using either one or two lag screws (six cases) or a cerclage wire (five cases). At a mean follow-up of 7 (range 6–9) years, most patients reported satisfactory finger function, even though some of the injuries healed with proximal interphalangeal joint incongruency (seven cases) or subluxation (four cases). Those treated by open reduction complained of more “loss of feeling” in the affected finger and those specifically treated by cerclage wire fixation reported more cold intolerance and had a significantly larger fixed flexion deformity (median, 30°: range 18–38°) and a smaller arc of motion (median, 48°: range 45–60°) at the proximal interphalangeal joint, despite having the best radiological outcomes. Closed reduction and transarticular Kirschner wire fixation produced satisfactory results, with none of the eight patients experiencing significant persistent symptoms despite a reduced arc of proximal interphalangeal joint flexion (median=75°; range 60–108°). The results of this relatively simple treatment appear at least as satisfactory as those obtained by the two techniques of open reduction and internal fixation, both of which were technically demanding.

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