Closed reduction and intramedullary fixation using Kirchner wires and plate osteosynthesis in the treatment of fractures of distal end of fifth metacarpal bone

Czech version

Authors: Robert Manek; Martin Vlček; Jaroslav Kalvach; Ivan Landor
Authors‘ workplace: 1. Ortopedická klinika 1. lékařské fakulty UK Praha a FN v Motole ; st Orthopaedic Clinic of First Faculty of Medicine of Charles University in Prague and Motol University Hospital, Prague, Czech Republic ¹
Published in: Úraz chir. 24., 2016, č.3

Overview

Objective:
To compare the therapeutic results of closed reduction with intramedullary stabilization using Kirschner wires and fixation with locking plates in the treatment of fractures of the distal part of the fifth metacarpal bone.

Material and methods:
Group “KDR” includes 14 patients with fractures of the head and neck of the fifth metacarpal treated by closed reduction and retrograde inserion of Kirschner wires. “APT” group contains 16 patients with the same fracture types treated by open reduction from a dorsolateral approach and stabilization by Aptus locking plates.

Results:
In the KDR group all fractures healed, but in five cases (35.7 %) the position of the bone fragments was unsatisfactory. In the APT group the fractures healed in 15 cases (93.8 %), in one patient (6.3 %) partial necrosis of the head of the fifth metacarpal occurred. In two cases (12.5 %) in the APT group there was healing in unsatisfactory fragment position. In the KDR group full flexion in the metacarpophalangeal joint was achieved in 9 patients (64.3 %) and in APT group in 14 cases (87.5 %). In two cases (14.2 %) in the KDR healing in rotational malposition of peripheral fragment was observed, while in the APT group this complication did not occur.

Conclusion:
In the tratment of fifth metacarpal head and neck fracture, the advantage of plate osteosynthesis is the ability to achieve precise anatomic reduction, which is the basis for good functional outcome. In the case of stabilization by Kirchner wires healing in rotational malposition of the peripheral fragment may occur more frequently since this deviation is not evaluable on X-rays.

Keywords:
Fifth metacarpal, fracture, angle stable plate, Kirschner wire.

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Labels

Surgery Traumatology Trauma surgery

Surgery in the early post-trauma period in patients with triage positive injuries

Comparsion of treatment methods and complitacions in pilon fractures of the tibia

Injuries of the Diaphragm

Article was published in

Trauma Surgery

2016 Issue 3