Comparison of internal fixation techniques in metacarpal fractures

Black, David M.; Mann, Ronald J.; Constine, Ronald; Daniels, A. U.

doi:10.1016/s0363-5023(85)80067-8

Cited by 122 publications

(62 citation statements)

References 12 publications

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“…[2][3][4]6,11,13,15,20,22,23] Surgical methods include percutaneous or open Kirschner wire fixation, intramedullary fixation, open or percutaneous interfragmentary screw fixation, and external fixation. [1,2,10,16,24,25] Kirschner wires are the most commonly used fixation materials after closed or open reduction. [2,15] However, late initiation of movement resulting in a stiff hand, pin tract infection, and pin migration are the disadvantages of this method.…”

Section: Introductionmentioning

confidence: 99%

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Results of surgical treatment in metacarpal shaft fractures using low profile mini plates

Aykut¹,

Öztürk²,

Özcan

et al. 2015

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Metacarpal fractures are among the most common fractures of the hand. They may lead to loss of function if treated improperly. These injuries can be treated conservatively. However, if significant shortening, rotational deformity and angulation occur, surgical treatment is required. In this article, results of metacarpal fractures treated with open reduction and internal fixation with mini plates were presented.

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Section: Introductionmentioning

confidence: 99%

“…[4,[9][10][11] The goals of treatment are restoration of length, correction of rotational deformity, if present, establishing adequate stability, proper soft tissue management, and early initiation of movement. The treatment of metacarpal shaft fractures can be further sub-classified as transverse, oblique, spiral, or comminuted based on the fracture geometry.…”

mentioning

confidence: 99%

Results of surgical treatment in metacarpal shaft fractures using low profile mini plates

Aykut¹,

Öztürk²,

Özcan

et al. 2015

Ulus Travma Acil Cerrahi Derg

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“…1 The tests were performed in a modified 3-point bending test in which the bone is fixed proximally (1) and load is applied on the distal apex (3). The third point is a breaking edge on the palmar diaphysis (2). Distances are standardised with four bicortical screws.…”

Section: Methodsmentioning

confidence: 99%

“…Usually the operated fractures are treated with early controlled passive motion to prevent adhesions and improve the clinical outcome [1]. Comparing the different techniques of osteosynthesis for metacarpal fracture stabilisation the combination of a dorsal plate and lag screw has been shown in biomechanical studies to be stronger than other fixation methods [2][3][4]. Prevel et al found that a three-dimensional design is associated with increased rigidity [5,6].…”

Section: Introductionmentioning

confidence: 99%

Higher stability with locking plates in hand surgery? Biomechanical investigation of the TriLock system in a fracture model

Hoelscher-Doht

Jansen

Meffert

et al. 2012

International Orthopaedics (SICOT)

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Purpose The aim of this study was to determine the biomechanical characteristics of locking plates with the TriLock system with different design and screw settings compared to a non-locking plate in a diaphyseal metacarpal fracture. Methods Oblique diaphyseal shaft fractures in porcine metacarpal bones were created in a biomechanical fracture model. After reduction they were fixed with three different locking plates with the TriLock interlocking mechanism or a non-locking linear plate in mono-or bicortical screw fixations. In load to failure tests the maximum load and stiffness were measured. Results For linear plates, the maximum load was higher for the non-locking plate compared with the locking plate. The maximum load could be increased for the locking plates using a double-row design and a higher screw number. No differences were found for the stiffness between all groups. In contrast to the non-locking plate, the mode of failure of the locking plates in many cases (86 %) was a loss of the interlocking mechanism. Conclusions The results suggest that the locking plates with the TriLock system achieve no higher stability compared to a non-locking plate in load to failure tests. Adaptions to increase the stability of the interlocking mechanism are desirable.

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“…The recommended treatment of these fractures has been open reduction and internal fixation with inter-fragmentary fixation or plate fixation [3,4]. However, due to the complications of open reduction, safer and effective methods of closed reduction and fixation of these fractures are being preferred.…”

Section: Introductionmentioning

confidence: 99%

A New Technique of Locked, Flexible Intramedullary Nailing of Spiral and Comminuted Fractures of the Metacarpals: A Series of 21 Cases

Agashe¹,

Phadke²,

Agashe³

et al. 2011

Hand (New York, N,Y.)

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Background Spiral and comminuted fractures of the metacarpals are rotationally and axially unstable fractures with a tendency to shorten, which in turn causes significant extensor lag and loss of grip strength. We have designed a new, cheap and locally developed method of locked intramedullary nailing of these metacarpal fractures. We are presenting the results of our first 21 patients with 22 fractures treated by closed, fluoroscopically assisted, intramedullary K-wiring with proximal locking done by a specially designed locking pin. Materials and Methods This was a retrospective, observational cohort study of all patients with spiral and comminuted fractures of metacarpals with minimum of 1 year of follow-up and average follow-up of 14 months (range, 12 to 26 months). The patients were evaluated clinico-radiologically using range of motion, extensor lag, time to healing, amount of collapse, angulation and rotation and complications. Results All fractures had healed uneventfully with average time to union being 8 weeks. Average metacarpal shortening was 2.04±0.95 mm, while the average post-operative angulation of the fracture was 4.81°±1.7. The metacarpophalangeal range-of-motion recovered almost fully with the average extensor lag being only 5.22°±2.42. Other than extensor tendinitis in two patients, there were no other complications.Conclusions This method is cosmetically appealing, provides stable fixation, avoids periosteal stripping associated with open reduction and is associated with very low complication rate, and thus can be safely and effectively used for the treatment of these difficult fractures.

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Comparison of internal fixation techniques in metacarpal fractures

Cited by 122 publications

References 12 publications

Results of surgical treatment in metacarpal shaft fractures using low profile mini plates

Results of surgical treatment in metacarpal shaft fractures using low profile mini plates

Higher stability with locking plates in hand surgery? Biomechanical investigation of the TriLock system in a fracture model

A New Technique of Locked, Flexible Intramedullary Nailing of Spiral and Comminuted Fractures of the Metacarpals: A Series of 21 Cases

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