Radiographic and Clinical Assessment of Intramedullary Nail Fixation for the Treatment of Unstable Metacarpal Fractures

Mirza, Ather; Mirza, Justin B.; Healy, Chris; Mathew, Vishaaq; Lee, Brian

doi:10.1177/1558944717695747

Cited by 9 publications

(13 citation statements)

References 15 publications

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“…Understanding the underlying anatomy of metacarpals is essential for surgical fixation and reconstruction (Rivlin et al, 2015). Metacarpal fractures lead to shortening of metacarpal length, with intramedullary nailing (IMN) reported to restore metacarpal length (Mirza et al, 2018). Our data reveals further information with use of radiographic imaging regarding metacarpal dimensions of length, neck width, narrowest body width, and narrowest medullary canal width.…”

Section: Discussionmentioning

confidence: 76%

Morphometric analysis of the second through fifth metacarpal through posteroanterior X‐Rays

et al. 2019

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Over the past 10 years, metacarpal fractures have had an annual incidence of 13.6 per 10,000 individuals. Literature has not reviewed anatomical variations through radiographic imaging, which may play a role in reducing postoperative complications. The purpose of this study was to use radiographic imaging to provide a detailed anatomy of the second through fifth metacarpals. This retrospective study measured length, neck width, narrowest body width, and narrowest medullary canal width of the second through fifth metacarpals through the use of posteroanterior X‐rays. Patients who were ≥18 years and received hand radiographs from January 2015 to July 2019 were included in this study. Those with acute injury or fracture of the metacarpal were excluded. Five hundred and seventy‐two metacarpals were included in this study, with 143 metacarpals measured each for the second through fifth metacarpal. The second metacarpal had the largest measured length, neck width, and narrowest body width at 68.72, 12.34, and 8.74 mm, respectively. The fifth metacarpal had the greatest average medullary canal width at 4.15 mm. This is the largest study in literature to comprehensively examine the anatomical variation of the second through fifth metacarpals. The second metacarpal had greatest dimensions except for canal width, which was the fifth metacarpal. Men almost consistently had greater metacarpal size when compared to women, and age was associated with second and third metacarpal canal width. The increased knowledge of metacarpal anatomy may potentially lay the foundation of further improvement of metacarpal implants and potentially reduce postoperative complications. Clin. Anat., 33:1014–1018, 2020. © 2019 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 76%

Morphometric analysis of the second through fifth metacarpal through posteroanterior X‐Rays

et al. 2019

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“…11,12 In addition, it allows for the use of a single nail, compared with unlocked nails that required multiple nails to fixate one fracture. 12 When using this technique, Mirza et al 7 found a 10% complication rate of IM Nail backing out, tendon irritation, and one case of a tendon rupture. 7 These complications required either revision or nail removal.…”

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confidence: 99%

“…12 When using this technique, Mirza et al 7 found a 10% complication rate of IM Nail backing out, tendon irritation, and one case of a tendon rupture. 7 These complications required either revision or nail removal. 7 Mirza et al also reported that patients commonly reported experiencing postoperative prominence and swelling near the base of the metacarpal.…”

mentioning

confidence: 99%

“… 2 , 3 Open reduction with plate fixation and closed reduction with intramedullary fixation (CRIF) have been reported to have comparable functional outcomes for extra-articular metacarpal fractures. 5 , 6 , 7 , 8 However, intramedullary fixation provides the advantages of a simplified technique, minimal soft tissue dissection, a smaller incision, reduced tendon irritation, and decreased scar formation. 8 …”

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confidence: 99%

“… 5 Since then, multiple intramedullary fixation devices and techniques have been described in the literature, including both locking and unlocking IM Nail systems for the treatment of all fracture types of the metacarpal neck, shaft, and base. 6 , 7 , 10 , 11 , 12 More recently, Orbay 11 and Orbay and Touhami 12 reported on the use of flexible, locked IM Nails for the treatment of unstable metacarpal fracture types. 11 , 12 With this technique, the IM Nail is percutaneously introduced into the medullary cavity fixating the fracture, and the proximal end of the nail is bent, locked, cut, and buried.…”

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confidence: 99%

See 2 more Smart Citations

Premeasured Intramedullary Nails for the Treatment of Metacarpal Fractures: Novel Instrumentation and Technique

Mirza¹,

Mirza²,

Thomas³

2020

Journal of Hand Surgery Global Online

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With nearly 36% of hand fractures occurring at the metacarpal, a variety of treatment interventions have been developed. Although many nondisplaced metacarpal fractures can be treated with conservative management, displaced, unstable, open, and extra-articular fractures require surgical attention. Compared with open reduction with plate fixation, closed reduction with intramedullary fixation has shown advantages of a simplified technique, minimal soft tissue dissection, and reduced tendon irritation and scar formation. The current study reports on the improved surgical technique associated with the use of novel instrumentation for the closed reduction and intramedullary fixation of extra-articular metacarpal fractures. The design and surgical technique of the premeasured Secure Intramedullary Nail improves fracture fixation, minimizing rotation and backing out, while reducing concerns for soft tissue irritation complications at the base of the metacarpal. Our reported case series suggests procedural efficiency, a low complication rate, and fast recovery for those with indicated extra-articular fractures.

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Antegrade intramedullary nailing in comminuted, open metacarpal bone fracture: maintenance of the length

Min

Kang

Shin

et al. 2021

Arch Orthop Trauma Surg

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Radiographic and Clinical Assessment of Intramedullary Nail Fixation for the Treatment of Unstable Metacarpal Fractures

Cited by 9 publications

References 15 publications

Morphometric analysis of the second through fifth metacarpal through posteroanterior X‐Rays

Morphometric analysis of the second through fifth metacarpal through posteroanterior X‐Rays

Premeasured Intramedullary Nails for the Treatment of Metacarpal Fractures: Novel Instrumentation and Technique

Antegrade intramedullary nailing in comminuted, open metacarpal bone fracture: maintenance of the length

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