%0 Journal Article
%T Percutaneous elastic intramedullary nailing of metacarpal fractures: Surgical technique and clinical results study
%A Riazuddin Mohammed
%A Mohamed Z Farook
%A Kevin Newman
%J Journal of Orthopaedic Surgery and Research
%D 2011
%I BioMed Central
%R 10.1186/1749-799x-6-37
%X A single K-wire is pre-bent in a lazy-S fashion with a sharp bend at approximately 5 millimeters and a longer smooth curve bent in the opposite direction. An initial entry point is made at the base of the metacarpal using a 2.5 mm drill by hand. The K-wire is inserted blunt end first in an antegrade manner and the fracture reduced as the wire is passed across the fracture site. With the wire acting as three-point fixation, early mobilisation is commenced at the metacarpo-phalangeal joint in a Futuro hand splint.The wire is usually removed with pliers post-operatively at four weeks in the fracture clinic.We studied internal fixation of 18 little finger and 2 ring finger metacarpal fractures from November 2007 to August 2009. The average age of the cohort was 25 years with 3 women and 17 men. The predominant mechanism was a punch injury with 5 diaphyseal and 15 metacarpal neck fractures. The time to surgical intervention was a mean 13 days (range 4 to 28 days). All fractures proceeded to bony union. The wire was extracted at an average of 4.4 weeks (range three to six weeks). At an average follow up of 8 weeks, one fracture had to be revised for failed fixation and three superficial wound infections needed antibiotic treatment.With this simple and minimally invasive technique performed as day-case surgery, all patients were able to start mobilisation immediately. The general outcome was good hand function with few complications.Hand injuries are very common resulting frequently in metacarpal and phalangeal fractures [1]. These commonly involve the active and working population especially in adolescents and young adults [2]. Though a majority of these fractures can be treated non-operatively, surgical intervention is indicated for certain intra-articular fractures, displaced and angulated fractures, rotational deformity, multiple injuries, irreducible and unstable dislocations; and those associated with significant soft tissue injury. Older literature quotes higher deg
%U http://www.josr-online.com/content/6/1/37