Treatment of Metacarpal Fractures using Transverse Kirschner-wire Fixation / 대한정형외과학회잡지

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. CONCLUSION: Transverse K-wire fixation and additional interfragmentary fixation of the metacarpal fractures can allow the full range of motion without the need to remove the K-wires. The clinical results were excellent.