The treatment of unstable fractures of fifth metacarpal bone by external fixator
Authors:
Boris Těknědžjan 1; Zuzana Posoldová 1; Tomáš Kozák 1; Radek Hart 1,2; Miloslav Pink 3
Authors‘ workplace:
2. Klinika traumatologie LF MU, Úrazová nemocnice Brno
; 3. Ortopedické oddělení, Nemocnice Třebíč
; 1. Ortopedicko-traumatologické oddělení, Nemocnice Znojmo
Published in:
Úraz chir. 20., 2012, č.4
Overview
INTRODUCTION:
Metacarpal fractures are the most common injuries of the hand. The aim of this study is to presented our experience with the external fixator.
MATERIALS AND METHODS:
From February 2009 to November 2012 we treated 60 patients with subcapital or diaphyseal fifth metacarpal closed fractures by using external fixator according to Ellis (Link, Hamburg, Germany). There were 5 women and 55 men. Average age at the time of surgery was 29 years (range from 14 to 96).
The external fixation was provided by original K-wires with thread placed transversely through the fractured metacarpal. Two K-wires were placed to the distal fragment of the fracture and other two K-wires were inserted in the proximal fragment. The wires were connected with the body of fixator. Appropriate post-operative care about external fixator was regularly provided.
RESULTS:
The external fixator was remove in outpatient ward after 8 weeks on average (range, 6 to 12). Two types of complication occured. Superficial pin track infection was found in five cases (8,3 %). In these cases were antibiotics administered orally. The infection spontaneously resolved after fixator removal after bone healing. The second complica-tion we observed was refracture. The refracture after removal of external fixation was observed in one case (1,6 %).
CONCLUSIONS:
The advantages of the treatment of metacarpal fractures with external fixation are less invasivity, simple removal of the osteosynthetic material, low economy cost and the lower risk of the injury of tendons. Our experience is satisfying and the incidence of complication is comparable literature source.
KEY WORDS:
external fixator, fracture of fifth metacarpal bone, osteosynthesis.
Sources
1. BOTTE, MJ., DAVIS JL, ROSE BA. Complications of smooth pin fixation of fractures and dislocations in the hand and wrist. Clin Ortop. 1992, 276, 194–201.
2. DAILIANA, Z., AGORASTAKIS. D. Use of a mini-external fixator for the treatment of hand fractures. J Hand Surg Am. 2009, 34, 630–636.
3. DRENTH, D.J., KLASEN, H.J. External fixation for phalangeal and metacarpal fractures. J Bone Joint Surg. 1998, 80, 227–230.
4. FREELAND, A.,GEISSLER,W. Operative treatment of common displaced and unstable fractures of the hand. J Bone Jt Surg. 2001, 83, 928–945.
5. FUSETTI, C., MEYER, H. Complications of plate fixation in metacarpal fractures. J Trauma. 2002, 52, 535–539.
6. POKORNÝ, V., PAŠA,L., VALENTOVÁ, J. Osteosyntéza dlouhých kostí ruky, Úraz chir. 2007, 15, 28–35.
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8. STERN, P.J., WIESER, M.J., REILLY D.G., Complications of plate fixation in the hand skeleton. Clin Orthop. 1987, 214, 59–65.
Labels
Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2012 Issue 4
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