Percutaneous Retrograde Intramedullary Pin Fixation for Isolated Metacarpal Shaft Fracture of the Little Finger

2010 ◽  
Vol 23 (4) ◽  
pp. 367 ◽  
Author(s):  
Soo Hong Han ◽  
Hyung Ku Yoon ◽  
Dong Eun Shin ◽  
Seung Chul Han ◽  
Young Woong Kim
Keyword(s):  
Shaft Fracture ◽  
Metacarpal Shaft ◽  
Pin Fixation ◽  
Little Finger

Percutaneous retrograde intramedullary single wire fixation for metacarpal shaft fracture of the little finger

2012 ◽  
Vol 23 (8) ◽  
pp. 883-887 ◽  
Author(s):  
Soo-Hong Han ◽  
Seung-Yong Rhee ◽  
Soon-Chul Lee ◽  
Seung-Chul Han ◽  
Yoon-Sik Cha
Keyword(s):  
Shaft Fracture ◽  
Single Wire ◽  
Metacarpal Shaft ◽  
Wire Fixation ◽  
Little Finger

An Isolated Ring Finger Metacarpal Shaft Fracture? – Beware An Associated Little Finger Carpometacarpal Joint Dislocation

2004 ◽  
Vol 29 (6) ◽  
pp. 629-631 ◽  
Author(s):  
ALPHONSUS K. S. CHONG ◽  
WINSTON Y. C. CHEW
Keyword(s):  
Ring Finger ◽  
Shaft Fracture ◽  
Metacarpal Fracture ◽  
Carpometacarpal Joint ◽  
Joint Injury ◽  
Joint Dislocation ◽  
Radiological Features ◽  
Metacarpal Shaft ◽  
Joint Dislocations ◽  
Little Finger

Dislocations of the ulnar carpometacarpal joint are easily missed because of a low index of suspicion as well as their subtle clinical and radiological features. Often, the presence of a more obvious adjacent injury also draws attention away from the carpometacarpal joint. Two cases of ring finger metacarpal shaft fractures with associated little finger carpometacarpal joint dislocations are presented. In both cases, the metacarpal fractures were diagnosed but the carpometacarpal joint dislocations were initially overlooked. The presence of an apparently isolated ring finger metacarpal fracture due to an indirect force should raise the possibility of an associated carpometacarpal joint injury.

scholarly journals Effect of oblique headless compression screw fixation for metacarpal shaft fracture: a biomechanical in vitro study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yung-Cheng Chiu ◽  
Tsung-Yu Ho ◽  
Yen-Nien Ting ◽  
Ming-Tzu Tsai ◽  
Heng-Li Huang ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Screw Fixation ◽  
Shaft Fracture ◽  
Metacarpal Bone ◽  
Entry Point ◽  
Fixation Method ◽  
Exit Point ◽  
Compression Screw ◽  
Headless Compression Screw ◽  
Metacarpal Shaft

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.

scholarly journals Bone plate fixation ability on the dorsal and lateral sides of a metacarpal shaft transverse fracture

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yung-Cheng Chiu ◽  
Cheng-En Hsu ◽  
Tsung-Yu Ho ◽  
Yen-Nien Ting ◽  
Ming-Tzu Tsai ◽  
...  
Keyword(s):  
Mechanical Strength ◽  
Locking Plate ◽  
Plate Fixation ◽  
Shaft Fracture ◽  
Bone Plate ◽  
Lateral Side ◽  
Lateral Plate ◽  
Fracture Force ◽  
Shaft Fractures ◽  
Metacarpal Shaft

Abstract Background Metacarpal shaft fractures are a common hand trauma. The current surgical fixation options for such fractures include percutaneous Kirschner wire pinning and nonlocking and locking plate fixation. Although bone plate fixation, compared with Kirschner wire pinning, has superior fixation ability, a consensus has not been reached on whether the bone plate is better placed on the dorsal or lateral side. Objective The purpose of this study was to evaluate the fixation of locking and regular bone plates on the dorsal and lateral sides of a metacarpal shaft fracture. Materials and methods Thirty-five artificial metacarpal bones were used in the experiment. Metacarpal shaft fractures were created using a saw blade, which were then treated with four types of fixation as follows: (1) a locking plate with four locking bicortical screws on the dorsal side (LP_D); (2) a locking plate with four locking bicortical screws on the lateral side (LP_L); (3) a regular plate with four regular bicortical screws on the dorsal side (RP_D); (4) a regular plate with four regular bicortical screws on the lateral side (RP_D); and (5) two K-wires (KWs). All specimens were tested through cantilever bending tests on a material testing system. The maximum fracture force and stiffness of the five fixation types were determined based on the force–displacement data. The maximum fracture force and stiffness of the specimens with metacarpal shaft fractures were first analyzed using one-way analysis of variance and Tukey’s test. Results The maximum fracture force results of the five types of metacarpal shaft fracture were as follows: LP_D group (230.1 ± 22.8 N, mean ± SD) ≅ RP_D group (228.2 ± 13.4 N) > KW group (94.0 ± 17.4 N) > LP_L group (59.0 ± 7.9 N) ≅ RP_L group (44.5 ± 3.4 N). In addition, the stiffness results of the five types of metacarpal shaft fracture were as follows: LP_D group (68.7 ± 14.0 N/mm) > RP_D group (54.9 ± 3.2 N/mm) > KW group (20.7 ± 5.8 N/mm) ≅ LP_L group (10.6 ± 1.7 N/mm) ≅ RP_L group (9.4 ± 1.2 N/mm). Conclusion According to our results, the mechanical strength offered by lateral plate fixation of a metacarpal shaft fracture is so low that even KW fixation can offer relatively superior mechanical strength; this is regardless of whether a locking or nonlocking plate is used for lateral plate fixation. Such fixation can reduce the probability of extensor tendon adhesion. Nevertheless, our results indicated that when lateral plate fixation is used for fixating a metacarpal shaft fracture in a clinical setting, whether the mechanical strength offered by such fixation would be strong enough to support bone union remains questionable.

An Evaluation of a Clinical Method to Assess Malunion of Little Finger Metacarpal Fractures

2007 ◽  
Vol 32 (6) ◽  
pp. 641-646 ◽  
Author(s):  
A. P. WESTBROOK ◽  
T. R. C. DAVIS
Keyword(s):  
Past History ◽  
Normal Subjects ◽  
The Other ◽  
Limits Of Agreement ◽  
Clinical Method ◽  
Metacarpal Shaft ◽  
Neck Fracture ◽  
History Of ◽  
Clinical Measurements ◽  
Little Finger

This study assessed the reliability, responsiveness and validity of two clinical measurements for the assessment of malunion of little finger metacarpal neck and shaft fractures. Both compared the relative lengths of the ring and little fingers in the injured and contralateral hands. One measurement was taken with the metacarpophalangeal joints extended (straight-MCP), and the other with them flexed to 90° (90-MCP). Ninety-five percent of the differences between the relative lengths of the ring and little fingers in the two hands of 50 normal subjects were less than 3 mm and the 95% limits of agreement for repeat measurements (intra-observer reproducibility) was ±1 mm for both measurements. Both measurements were significantly altered in a group of 218 patients with a past history of a metacarpal shaft or neck fracture. Although both measurements correlated with the patient’s assessment of the cosmetic result ( p = 0.01), neither measurement correlated with the severity of palmar angulation of the fracture at presentation. It is concluded that these measurements are reliable and responsive, but their validity is uncertain.

Metacarpal Shaft Fracture Treated by Closed Reduction and Percutaneous Intramedullary K-wire Fixationv

1998 ◽  
Vol 11 (1) ◽  
pp. 100
Author(s):  
Soo Joong Choi ◽  
Chang Kyun Lim ◽  
Ho Guen Chang ◽  
Jun Dong Chang ◽  
Chang Ju Lee
Keyword(s):  
Closed Reduction ◽  
Shaft Fracture ◽  
Metacarpal Shaft

Comparison of Bending Strength among Plate, Steinmann Pin, and Headless Compression Screw Fixations for Proximal Ulnar Shaft Fracture in Sawbones

2020 ◽  
Vol 25 (4) ◽  
pp. 267-273
Author(s):  
Jinyoung Han ◽  
Jin Rok Oh ◽  
Jaewoong Um
Keyword(s):  
Bending Strength ◽  
Plate Fixation ◽  
Soft Tissue Injury ◽  
Shaft Fracture ◽  
Compression Screw ◽  
Proximal Ulna ◽  
Headless Compression Screw ◽  
Fixation Group ◽  
Pin Fixation ◽  
Steinmann Pin

Purpose: Although plate osteosynthesis is commonly used to treat proximal ulna fracture, its treatment method is controversial because of complications such as large incision, long operation time, and soft tissue injury. Therefore, intramedullary headless compression screw (HCS) and Steinmann pin are considered as alternative treatment options. In this study, we aim to compare bending strength of plate and cortical screws, HCS, and Steinmann pin for proximal ulnar shaft fracture with sawbone. Methods: Transverse type fractures were made intentionally at the distal 7 cm from the proximal end of ulna sawbones and fixated with plate, HCS, and Steinmann pin after reduction. Three-point bending tests were performed with total of 21 sawbones, seven pieces for each group. Results: Average ultimate bending strength for each group was as follows; 521.7N for plate fixation group, 706.4N for HCS fixation group, and 812.6N for Steinmann pin fixation group. Statistically significant results were observed among the three groups (p<0.01). When two groups were compared separately, Steinmann pin fixation and plate fixation (p<0.01), Steinmann pin and HCS fixation (p=0.047) showed statistical significance. There was a significant trend between HCS and plate fixation group (p=0.064).Conclusion: HCS and Steinmann pin fixation showed higher bending strength when compared to plate fixation for proximal ulnar shaft fracture in sawbone. Although further studies are needed, HCS and Steinmann pin fixation are promising fixation methods that may be used as an alternative to plate fixation.

A Prospective Study of the Treatment of Fractures of the Little Finger Metacarpal Shaft with a Short Hand Cast

2004 ◽  
Vol 29 (3) ◽  
pp. 214-217 ◽  
Author(s):  
U. K. DEBNATH ◽  
R. S. NASSAB ◽  
J. A. ONI ◽  
T. R. C. DAVIS
Keyword(s):  
Prospective Study ◽  
Wrist Joint ◽  
Fracture Reduction ◽  
Shaft Fractures ◽  
Metacarpal Shaft ◽  
Short Hand ◽  
A Prospective Study ◽  
Little Finger ◽  
Angular Deformities

This prospective study describes the use of a short hand cast, which leaves the finger metacarpophalangeal and wrist joint free, for angularly displaced little finger metacarpal shaft fractures which require reduction. Twenty-seven patients with a mean age of 25 (range, 16–39) years with little finger or combined ring and little finger displaced metacarpal shaft fractures were prospectively recruited. All were treated by closed fracture reduction and immobilization in the cast. Patients were followed up at 1 week, 4 weeks, and between 6 and 12 months. At each of these follow-up visits posteroanterior and lateral radiographs of the metacarpals were performed to assess angulation of the fracture. The mean initial angulation of the 17 little finger metacarpal fractures with complete follow up was 40° (range, 20–60°). Their mean final angulation at 6 to 12 months was 8°. The fracture reduction was lost in three patients in whom the final angular deformities were 15° (one patient) and 20° (two patients).

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