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Abstract
Purpose
To analyze the clinical results of transverse Kirschner (K)-wire fixation for metacarpal fractures.
Materials and Methods
Between May 2002 and May 2005, thirty-four cases (thirty-nine fingers) of unstable metacarpal fractures underwent a closed reduction and transverse K-wire fixation. The neck, shaft and base fractures of the metacarpals except the thumb were included. The follow-up period ranged from 12 months to 3 years and 4 months (mean; 2 years and 1 month). Interfragmentary fixation was performed on 24 cases. A short arm splint was maintained until postoperative 4 weeks, after which the full range of motion was permitted. The K-wires were removed after achieving the full-range of motion or pin-site infection.
Results
At the last follow-up, there was no limitation of motion and discomfort during the daily living activities. Five cases had skin problems around the tip of the K-wire. All cases, except for three cases with angulation over 20 degrees, had achieved the union under five degrees (average 3.24 degrees dorsal angulation). Three cases had minimal rotational deformities but they did not complain of discomfort. The one case of nonunion, in whom the K-wires had been removed four weeks after surgery, underwent plate fixation and a bone graft.
Figures and Tables
Fig. 1
Plain x-rays of the left hand (M/45) show a long oblique fracture of the 4th metacarpal fixed with a percutaneous mini-screw and 4 transverse K-wires (A, initial AP view; B, initial oblique view; C, postoperative AP view; D, postoperative 2 months oblique view).
Fig. 2
Plain x-rays of the left hand (M/32) show a long oblique fracture of the 2nd metacarpal fixed with interfragmentary K-wire and 3 transverse K-wires (A, initial AP view; B, initial lateral view; C, postoperative AP view; D, postoperative 4 months AP view).
Fig. 3
Plain x-rays of the left hand (F/30) show a short oblique fracture of the 3rd metacarpal and a migrated K-wire on the follow-up (A, initial oblique view; B, post-accident 2 weeks oblique view; C, postoperative AP view; D, postoperative 3 months AP view).
Fig. 4
Plain x-rays of right hand (M/17) show nonunion of the fracture of the 4th metacarpal (A, initial oblique view; B, postoperative AP view; C, postoperative oblique view; D, postoperative 8 weeks oblique view; E, 2nd postoperative 2 months oblique view; F, 2nd postoperative 2 months lateral view).
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