Journal List > J Korean Fract Soc > v.24(1) > 1037848

Kim, Kim, Jung, and Kim: Antegrade Intramedullary Prebent K-wire Fixation for the 5th Metacarpal Neck Fracture

Abstract

Purpose

To evaluate radiological and clinical results of the antegrade intramedullary prebent K-wire fixation for the 5th metacarpal neck fracture.

Materials and Methods

Between January, 2006 and December, 2009, 31 patients with displaced neck fracture of the fifth metacarpal who received antegrade intramedullary prebent K-wire fixation were included in this study. Radiological and clinical outcome evaluations were performed.

Results

All the fractures were completely united. In the oblique radiographs, the average of preoperative angulation was corrected from 38.9° to 4.4°. The average difference between postoperative and final follow-up was 1.2°. Clinical outcomes were satisfactory except for one patient who had sustained ulnar nerve dorsal branch injury during surgery.

Conclusion

Antegrade intramedullary prebent K-wire fixation may be preferentially considered as one of the best ways to fix the displaced neck fractures of the fifth metacarpal.

Figures and Tables

Fig. 1
The prebent wire is firmly fixed to the drill chuck.
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Fig. 2
The wire is inserted through the ulnar cortex of the little finger metacarpal base, after 5 mm incision.
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Fig. 3
Drive the wire into the fracture site like a guide pin of the interlocking nail system.
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Fig. 4
Prebent tip of the wire is secured at the subchondral bone of the metacarpal head after closed reduction under the C-arm.
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Fig. 5
A 46-year old man sustains a 5th metacarpal neck fracture with 35° angulation deformity in oblique radiograph.
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Fig. 6
Postoperative radiographs show 0° residual angulation after pin fixation.
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Fig. 7
Four-month postoperative radiographs show good union without any reduction loss.
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Fig. 8
Phoptograhs show full range of motion.
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Fig. 9
The height of the K-wire is proportionate to the bending angle. H: Thickness of K-wire+h, b: Length of prebent wire, a: Angle, h: b sin a.
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Table 1
Grading for clinical results
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Excellent: 500~476, Good: 475~451, Fair: 450~426, Poor: <425. From Kim et al10) and Steel16)

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