Opening-wedge V-shaped corrective osteotomy for malunited fractures of metacarpal bones

Izmalkov, S.N.; Semenkin, Oleg M.; Bratiichuk, Alexandr N.; Litvinov, S.A.

doi:10.1016/j.jor.2019.10.013

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…Our decision to utilize artificial bones aimed to ensure uniformity and consistency across all test samples, facilitating a fair comparison of fixation abilities among various osteosynthetic techniques. The selection of artificial bones aligns with guidelines provided by the American Society for Testing and Materials (F-1839-08) (17,(27)(28), which recognizes artificial bones as the most appropriate material for such research endeavors. This choice also ensures compliance with ethical considerations regarding using human or animal specimens.…”

Section: Discussionmentioning

confidence: 85%

“…The defect's size and shape significantly influence the stability of internal fixation. In clinical settings, the force-deforming metacarpal shaft fractures are typically directed towards the volar side, resulting in most malunited metacarpal fractures being dorsally angulated [16][17][18]. Our wedge-shaped bone defect metacarpal fracture model is designed to replicate clinical observations, showing that volar defects are more common than dorsal defects or a combination of both.…”

Section: Discussionmentioning

confidence: 99%

“…We created a uniform wedge-shaped bone defect fracture model in the middle of the metacarpal shaft to investigate which fixation method would achieve the best mechanical strength. This facilitates a more reference-worthy biomechanical study on fracture fixation methods [16][17][18].…”

Section: Preparation Of Artificial Metacarpal Bone Specimensmentioning

confidence: 99%

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Biomechanical analysis of plate versus K-wire fixation for metacarpal shaft fractures with wedge-shaped bone defects

Chiu,

Ho,

Hsu

et al. 2024

BMC Musculoskelet Disord

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Background Metacarpal shaft fracture is a common type of hand fracture. Numerous studies have explored fixing transverse fractures in the midshaft of the metacarpal bone. However, this section of the metacarpal bone is often susceptible to high-energy injury, resulting in comminuted fracture or bone loss. In such cases, wedge-shaped bone defects can develop in the metacarpal shaft, increasing the difficulty of performing fracture fixation. Notably, the research on this type of fracture fixation is limited. This study compared the abilities of four fixation methods to fix metacarpal shaft fractures with wedge-shaped bone defects. Methods In total, 28 artificial metacarpal bones were used. To create wedge-shaped bone defects, an electric saw was used to create metacarpal shaft fractures at the midshaft of each bone. The artificial metacarpal bones were then divided into four groups for fixation. The bones in the first group were fixed with a dorsal locked plate (DP group), those in the second group were fixed with a volar locked plate (VP group), and those in the third group were fixed by combining dorsal and volar locked plates (DP + VP group), and those in the fourth group were fixed with two K-wires (2 K group). Cantilever bending tests were conducted using a material testing machine to measure yielding force and stiffness. The four groups’ fixation capabilities were then assessed through analysis of variance and Tukey’s test. Results The DP + VP group (164.1±44.0 N) achieved a significantly higher yielding force relative to the 2 K group (50.7 ± 8.9 N); the DP group (13.6 ± 3.0 N) and VP group (12.3 ± 1.0 N) did not differ significantly in terms of yielding force, with both achieving lower yielding forces relative to the DP + VP group and 2 K group. The DP + VP group (19.8±6.3 N/mm) achieved the highest level of stiffness, and the other three groups did not differ significantly in terms of stiffness (2 K group, 5.4 ± 1.1 N/mm; DP group, 4.0 ± 0.9 N/mm; VP group, 3.9 ± 1.9 N/mm). Conclusions The fixation method involving the combined use of dorsal and volar locked plates (DP + VP group) resulted in optimal outcomes with respect to fixing metacarpal shaft fractures with volar wedge bone defects.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Biomechanical analysis of plate versus K-wire fixation for metacarpal shaft fractures with wedge-shaped bone defects

Chiu,

Ho,

Hsu

et al. 2024

BMC Musculoskelet Disord

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A Minimally Invasive Technique for Correcting Extra-Articular Malunions of Metacarpal Fractures

Han,

Zhang,

et al. 2024

Preprint

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Purpose This study aimed to introduce a minimally invasive technique for correcting malunions of extra-articular metacarpal fractures followed by percutaneous fixation with a cemented K-wire frame. Methods From January 2018 to January 2022, 31 patients (31 malunions of extra-articular metacarpal fractures) were treated. The mean age of the patients was 32 years (range, 21–52 years). There were 25 fifth, 4 fourth, 1 third, and 1 second metacarpal malunions. The range of motion of the finger was assessed based on the total active motion scoring system of American Society for Surgery of the Hand. The motion was graded as excellent (85–100%), good (70–84%), fair (50–69%), and poor (below 50% based on a comparison of the opposite finger. The aesthetic appearance of the hand was evaluated based on the 10-cm visual analogue scale. Patient satisfaction was assessed using the Short Assessment of Patient Satisfaction (SAPS; 0–10, very dissatisfied; 11–18, dissatisfied; 19–26, satisfied; 27–28, very satisfied). Results Bone healing was achieved in all patients after a mean of 5.4 weeks (range, 4–10 weeks). The mean follow-up period was 27 months (range, 24–33 months). The mean preoperative TAM scale was 233° (range, 185°–288°), and the postoperative scale was 263° (range, 235°–290°). There were 8 excellent, 19 good, and 1 fair result. There were 15 very satisfied and 13 satisfied results. The mean preoperative aesthetic appearance of the hand was 7 cm (range, 5 cm – 8 cm), and the postoperative appearance was 10 cm (range, 9 cm – 10 cm). Conclusion The minimally invasive technique is effective for correcting extra-articular malunions of metacarpal fractures. The rigid fixation allows fracture healing and early motion of the injured hand. The technique improves hand function, patient satisfaction, and the aesthetic appearance of the hand. Level of Evidence Therapeutic study, Level IVa.

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Metacarpals and phalanges malunion: a narrative review

Daher,

Ghoul,

Salameh

et al. 2023

EGOJ

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Malunions are fractures that have healed with a deformity. Multiple abnormalities can coexist, but only one usually takes the lead causing symptoms, such as bone shortening, finger scissoring, etc. It is mainly caused by insufficient reduction. Malunions of the metacarpals are usually apex dorsal, while malunions of the phalanx tend to angulate volarly. Each patient with malunion should be assessed individually and treated conservatively if there is little to no functional impairment. Surgeries can be used to treat individuals with angular and rotational deformity.

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Opening-wedge V-shaped corrective osteotomy for malunited fractures of metacarpal bones

Cited by 3 publications

References 13 publications

Biomechanical analysis of plate versus K-wire fixation for metacarpal shaft fractures with wedge-shaped bone defects

Biomechanical analysis of plate versus K-wire fixation for metacarpal shaft fractures with wedge-shaped bone defects

A Minimally Invasive Technique for Correcting Extra-Articular Malunions of Metacarpal Fractures

Metacarpals and phalanges malunion: a narrative review

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