scholarly journals TREATMENT OF DIAPHYSEAL FRACTURES OF THE METACARPAL BONES

2015 ◽  
Vol 8 (2) ◽  
Author(s):  
Saodat Asilova ◽  
Azizjon Khaydarov
Keyword(s):  
Hand Function ◽  
Full Recovery ◽  
Wedge Osteotomy ◽  
Kirschner Wires ◽  
Metacarpal Bones ◽  
Diaphyseal Fractures

Presented the experience of the application of stable osteosynthesisby three Kirschner wires on diaphyseal fractures of the metacarpal bones at 74 patients.Indications for osteosynthesiswas opened (6%), closed (94%), non-united, mal-unitedfractures and false joints of metacarpal bonesdiaphysis. Patients were performed intraosseous anesthesia atdistal epimetaphysisarea of radial bone.Describeda method of operation extramedullaryosteosynthesis using three Kirschner wires. Also,describedmethod of wedge osteotomy for full recovery of hand function. Good results were obtained in 83.1% of patients, satisfactory at 13.6%, and unsatisfactory results in 3.4% of patients

Corrective osteotomy for malunited metacarpal fractures: long-term results of a novel technique

2015 ◽  
Vol 40 (8) ◽  
pp. 840-845 ◽  
Author(s):  
K. Karthik ◽  
R. Tahmassebi ◽  
R. S. Khakha ◽  
J. Compson
Keyword(s):  
Plate Fixation ◽  
Hand Function ◽  
Corrective Osteotomy ◽  
Long Term Results ◽  
Wedge Osteotomy ◽  
Dominant Hand ◽  
Level Of Evidence ◽  
Metacarpal Fractures

Symptomatic malunited metacarpal fractures can significantly affect hand function. We retrospectively reviewed the results of our technique of corrective osteotomy in 14 malunited metacarpal fractures (12 patients) with an average age of 30 years (range 18–49) from January 2005 to December 2011. The dominant hand was involved in nine patients and all except one were male. The malunited metacarpals demonstrated mean dorsal apex angulation of 43° (range 33°–72°) with apparent metacarpal shortening. All except three cases had rotational deformity. All patients underwent surgical correction of the deformity using our described technique of closing wedge osteotomy using temporary intramedullary K-wire and plate fixation. At a mean follow-up of 46 months (range 12–78), the DASH scores improved significantly ( p < 0.001). All our patients scored ‘excellent’ according to the Büchler criteria and at final follow-up had returned to pre-injury work and sports activities. Our technique is safe, easily performed and can be adapted to correct a range of deformities. Level of evidence: Level IV

scholarly journals Treatment of Humeral Diaphyseal Fractures with Flexible Intramedullary Wires (Kirschner Wires): About 40 Cases

2021 ◽  
Vol 7 (1) ◽  
pp. 31-33
Author(s):  
  Youness Dahmani ◽  
Ayoub Mjidila ◽  
Reda Allah Bassir ◽  
Moncef Boufettal ◽  
Mohamed Kharmaz ◽  
...  
Keyword(s):  
Kirschner Wires ◽  
Diaphyseal Fractures

scholarly journals Volar Dislocation of the Fourth and Fifth Carpometacarpal Joint Associated with Hamate Hook Fracture: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Natsumi Saka ◽  
Hirotada Matsui ◽  
Hideki Tsuji
Keyword(s):  
Carpometacarpal Joint ◽  
Kirschner Wires ◽  
Rare Injury ◽  
Intraoperative Computed Tomography ◽  
Flexor Carpi Ulnaris ◽  
Metacarpal Bones ◽  
Hamate Hook Fracture ◽  
Ligamentous Structure ◽  
Displaced Fracture ◽  
Cmc Joint

We report a case of volar fourth and fifth carpometacarpal (CMC) joint dislocation complicated by a hamate hook fracture. The CMC joint was reduced in a closed fashion and temporally fixed with Kirschner wires. Using intraoperative computed tomography, the displaced fracture of the hamate hook was reduced by open reduction and internal fixation and fixed with a screw. We suggest that this rare injury was caused by the over contraction of the flexor carpi ulnaris and avulsion force from the ligamentous structure around the pisiform, hamate, and metacarpal bones.

Open Reduction and Internal Fixation Using Plate and Screws Versus Percutaneous Kirschner Wires Fixation for Second and Third Metacarpal Bones Fractures: A Meta-analysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Karim Samir Masoud ◽  
Ahmad Fathi El Sherif ◽  
Raghda Elsayed Tallal ◽  
Mahmoud Mahrous Mohamed Waly
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Functional Results ◽  
Kirschner Wires ◽  
Metacarpal Fractures ◽  
Metacarpal Bones ◽  
Surgical Fixation ◽  
Type Of Fracture

Abstract Background Metacarpal fractures are among the most common fractures of the skeletal system and account for 36 % of hand and wrist fractures. Aim of the Work To determine the functional outcome and postoperative complications for both these surgical techniques in the treatment of second and third metacarpal bones fractures. Patients and Methods The systematic review was restricted to clinical studies of both these surgical techniques in the treatment of closed second and third metacarpal fractures. We reviewed studies that include management of metacarpal fractures with open reduction and internal fixation using plate and screws versus percutaneous crossed Kirschner wires fixation. Results No specification was made about the type of fracture, other than shaft fractures located in the second and the third metacarpal. All fractures were operated because of instability, angulations’ or rotational deformity. No comparison can therefore be made between fracture type (i.e. spiral, oblique) and functional results. As all studies reported identical indication for surgical fixation a comparison between type of fixation and functional result can be made. Conclusion Based on the reported results there is no evidence to suggest one fixation technique over another. The reported complications however for ORIF and K-wire fixation in the treatment of metacarpal fractures are unmistakably different for the two types of fixation.

CORRECTIVE OSTEOTOMY AND LOCAL BONE GRAFTING FOR EXTRA-ARTICULAR MALUNION OF THE PROXIMAL PHALANX

Hand Surgery ◽  
2012 ◽  
Vol 17 (03) ◽  
pp. 399-403
Author(s):  
John T. Capo ◽  
Ben Shamian ◽  
Philip K. Lim
Keyword(s):  
Bone Graft ◽  
Hand Function ◽  
Corrective Osteotomy ◽  
Proximal Phalanx ◽  
Wedge Osteotomy ◽  
Angular Deformity ◽  
Opening Wedge ◽  
Local Bone ◽  
Dual Plating ◽  
Osteotomy Technique

Corrective osteotomies are often utilised to treat finger deformities that may occur due to a phalangeal malunion. Rotational or angular malalignment, in addition to shortening of the digit may negatively affect hand function and be aesthetically displeasing. Thorough preoperative examination of the malunion and its associated deformities is crucial in determining the type of osteotomy technique to be used. Osteotomies can create bony defects that need to be filled with bone graft or some type of graft substitute. We describe an opening wedge osteotomy with local cancellous bone graft combined with dual plating to treat a dorsal angular deformity in a proximal phalangeal malunion.

scholarly journals A Giant Solitary Exostosis of the Lower Ulna in a Child

2013 ◽  
Vol 1 (1) ◽  
pp. 30-32
Author(s):  
Md Anwarul Haque ◽  
Md Emdadul Haque ◽  
Md Saiful Islam ◽  
Mamunur Rashid Chowdhury
Keyword(s):  
Medical Journal ◽  
Local Recurrence ◽  
Hand Function ◽  
Wedge Osteotomy ◽  
Community Based ◽  
Distal Ulna ◽  
Rare Presentation ◽  
Normal Bone ◽  
Bone Length ◽  
Fibular Autograft

Forearm deformity secondary to giant solitary ulnar exostosis is rare. Here we described a rare presentation of symptomatic solitary giant exostosis involving the distal ulna resulting in ulnar bowing of the forearm in a five-years old girl. The tumour was completely resected and the defect was reconstructed with non vascularised fibular autograft. A wedge osteotomy was performed on the radius to correct the deformity. Nine months after surgery, the fibular autograft has fully incorporated and the deformity remains corrected with normal bone length and excellent hand function. There is no evidence of local recurrence. DOI: http://dx.doi.org/10.3329/cbmj.v1i1.13851 Community Based Medical Journal Vol.1(1) 2012 30-32

scholarly journals Treatment of wrist deformities in children with arthrogryposis multiplex congenita

2016 ◽  
Vol 4 (1) ◽  
pp. 26-36
Author(s):  
Evgeniya A Kochenova ◽  
Olga E Agranovich ◽  
Margarita V Savina
Keyword(s):  
Spinal Cord ◽  
Hand Function ◽  
Flexion Contracture ◽  
Spinal Cord Lesion ◽  
Wedge Osteotomy ◽  
Arthrogryposis Multiplex Congenita ◽  
Spinal Cord Lesions ◽  
Ulnar Deviation ◽  
Tendon Transfers ◽  
Cord Lesion

Introduction: Treatment of wrist contractures in children with arthrogryposis multiplex congenita (AMC) is extremely problematic because of the high incidence of recurrence. This study aimed to improve the outcome of wrist contracture treatment in children with AMC.Materials and Methods: A total of 90 patients (162 wrists) were examined and treated. Patients were assessed using a number of clinical, radiological, and electrophysiological examinations. There are several different clinical variants of wrist contracture, including flexion contracture of the wrist, flexion contracture associated with ulnar deviation, and isolated ulnar deviation of the wrist. Patients were divided into three groups according to the level of spinal cord lesion: С6-С7, С5-С8, and С5-Th1. As the number of damaged spinal cord segments increased, the amplitude of passive and active movements, degree of passive correction, muscle power, and wrist function decreased. Surgical treatment involved the following three approaches: tendon transfers, tendon transfers and carpal wedge osteotomy, and tendon transfers with carpal wedge osteotomy and shortened osteotomy of the forearm.Results: Analysis of treatment results showed that patients with segmental spinal cord lesions at the  С6-С7 and С5-С8 level were mostly associated with a good outcome, whereas patients with lesions at the  С5-Th1 level achieved satisfactory outcomes.Conclusions: Patients with segmental lesions of the spinal cord at the С6-С7 and С5-С8 level were associated with restoration of active wrist extension up to the neutral position or more and were expected to achieve significant improvement of hand function. Patients with spinal cord lesions at the C5-Th1 level exhibited significant lesions of the muscles, along with bone deformities. Consequently, surgical treatment could only achieve functional wrist position with minimal improvement of hand function. Using differential approaches in the treatment of wrist contracture that are selected by determining the level of spinal cord lesion will enable physicians to predict the outcome and improve the function and appearance of the wrist.

scholarly journals Clinical and Radiographic Aspects of Metacarpal Remodeling Secondary to a Rubber Band (Latex) Compression in a Dog

2020 ◽  
Vol 48 ◽  
Author(s):  
Tadeu Basualdo Junior ◽  
Joyce Katiuccia Medeiros Ramos Carvalho ◽  
João Pedro Brochado Souza ◽  
Márcio Virgílio Figueiredo Da Silva ◽  
Joyce Maira De Araújo ◽  
...  
Keyword(s):  
Foreign Body ◽  
Bone Remodeling ◽  
Serum Biochemistry ◽  
Rubber Band ◽  
Full Recovery ◽  
Post Surgery ◽  
Time Period ◽  
Thoracic Limb ◽  
Metacarpal Bones ◽  
Anti Inflammatory

Background: Musculoskeletal disorders are a common complaint in veterinary small animal casuistic. Along with fractures, degenerative and of carcinogenic etiology are the most frequent and radiographic lesion pattern at these diseases is relative well defined. However, traumatic lesions, considering its innumerous possibilities, may cause unusual clinical and radiographic signs which will delay diagnosis and consequently, adequate treatment. A case of bone osteolysis caused by a compressive trauma by a rubber band is described with its clinical, laboratorial and radiographic aspects.Case: A 2-year-old female dog was attended at the Veterinary Hospital of the Dom Bosco Catholic University (UCDB), with main complaint being an unresponsive to treatment lesion at the left thoracic limb. At physical examination it was observed lameness of the left thoracic limb with an ulcerative lesion at the palmar surface. At the center of the ulcer a 0.3 cm line shaped yellow object was identified, similar to a rubber band. Traction was made and the object distended 5 cm without breaking nor leaving the injury. Showing signs of discomfort, the patient was then sedated for further manipulation. A blood sample for complete blood count and serum biochemistry was collected and radiographic image of the left carpometacarpal-phalangeal region was acquired. Blood analysis revealed moderate thrombocytopenia with an unremarkable serum biochemistry profile (alanine aminotransferase, alkaline phosphatase, creatinine and urea). It was observed metacarpals with increased radiopacity in bone tissue in the mid-diaphysis topography of the II, III, IV and V metacarpal bones, presence of bone remodeling with radiolucent area and slight bone loss (osteolysis) in the mid-diaphysis associated with discrete sclerosis of the medullary cavity of the II, III and V metacarpals. The patient was submitted to surgery and a 3 cm incision was made following the way of the foreign body, with a small traction the object was removed, confirming the presence of a rubber band. Post-surgery prescription included systemic antibiotic, non-steroidal anti-inflammatory, analgesic and topical ointment. Twenty-two days post-surgery, at revaluation, it was observed only discrete improvement of bone remodeling of V metacarpal but with complete wound healing and full recovery of the lameness.Discussion: It was unclear the reason that led to the presence of the rubber band. Unfortunately, the owner could only complaint about at wound that would not heal for weeks. The best hypothesis was the possible use of a beauty accessory after a bathing service. Considering the patient’s long hair, detachment of any accessory to a rubber band base could have gone unnoticed. Definition regarding the time period since the initial trauma would define for how long the compression was necessary to induce metacarpal remodeling, but the presence of the foreign body and consequently, continuous stimulus of inflammation, would not permit a precise definition regarding the time period of the lesion, even if histopathology was authorized. Surgical removal of the rubber band associated with non-steroidal anti-inflammatory, analgesic, systemic and topical antibiotic (ointment) was considered satisfactory, leading to considerable improvement (normal gait) of the nociception and lameness at day three post-intervention and despite persistence of the bone radiographic aspect, full recovery of the skin lesion at day twenty-two.

scholarly journals Preexisting lesions associated with complete diaphyseal fractures of the third metacarpal bone in 12 Thoroughbred racehorses

2017 ◽  
Vol 29 (4) ◽  
pp. 437-441 ◽  
Author(s):  
Sarah N. Gray ◽  
Mathieu Spriet ◽  
Tanya C. Garcia ◽  
Francisco A. Uzal ◽  
Susan M. Stover
Keyword(s):  
Callus Formation ◽  
Metacarpal Bone ◽  
Diaphyseal Fracture ◽  
The Third ◽  
Bone Injury ◽  
Thoroughbred Racehorses ◽  
Metacarpal Bones ◽  
Periosteal Surface ◽  
Diaphyseal Fractures ◽  
Bone Callus

We characterized features of complete diaphyseal fractures of third metacarpal bones in Thoroughbred racehorses. Given that stress fractures are known to occur in the third metacarpal bone, an additional aim was to determine if complete fractures are associated with signs of a preexisting incomplete stress fracture. Bilateral metacarpi from 12 Thoroughbred racehorses euthanized because of complete unilateral metacarpal diaphyseal fracture were examined visually and radiographically. Open, comminuted, transverse or short oblique fractures occurred in the middle of the diaphysis or supracondylar region. Periosteal surface discoloration and bone callus formation contiguous with the fracture line were present in fractured bones. All contralateral intact metacarpi had gross anatomic lesions, and 10 had radiographic abnormalities similar to those observed on fractured metacarpi. Catastrophic metacarpal fractures occurred in racehorses with bilateral evidence of preexisting bone injury.

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