Internal Fixation of Oblique Metacarpal Fractures

Firoozbakhsh, Keikhosrow; Moneim, Moheb S.; Doherty, William J.; Naraghi, Fred F.

doi:10.1097/00003086-199604000-00036

Cited by 24 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, plates have demonstrated unsatisfactory complication rates, including high rates of implant removal, stiffness, nonunion, and hardware failure 23–25 . Furthermore, dorsal lag screws alone have demonstrated inferior strength compared to plating, “intramedullary rods,” and crossed K-wires 16 . Immobilization is shortened for this technique provided construct strength in an effort to initiate early range of motion and reduce risk of stiffness.…”

Section: Discussionmentioning

confidence: 99%

“…[23][24][25] Furthermore, dorsal lag screws alone have demonstrated inferior strength compared to plating, "intramedullary rods," and crossed K-wires. 16 Immobilization is shortened for this technique provided construct strength in an effort to initiate early range of motion and reduce risk of stiffness.…”

Section: Discussionmentioning

confidence: 99%

“…Two dorsal lag screws alone were the weakest compared to all other tested constructs, and nearly 50% weaker than dorsal plates in compression and bending. 16 Intramedullary screws have been popularized for their strength and low reported complication profile, including greater functional scores, improved grip strength, and biomechanical properties more similar to native MC compared to traditional plate and screws. [17][18][19] However, they should be used cautiously as a sole fixation method in long oblique and spiral shaft fractures, as they may malreduce the fracture during insertion.…”

mentioning

confidence: 99%

“…Early biomechanical studies of spiral MC fractures demonstrated that single compression screws provide the greatest torsional and bending strength over numerous other fixation methods including crossed K-wires, interosseous loops, dorsal mini-plates, and K-wire plus cerclage wire 15 . In oblique-oriented fractures, Firoozbakhsh et al 16 demonstrated dorsal plating with lag screws and “intramedullary rod” (utilizing bouquet pinning with 5 K-wires) to be equivalent; both techniques were superior to alternatives (2 lag screws, crossed K-wires, and intramedullary rod from paired K-wires) in compressive strength. Two dorsal lag screws alone were the weakest compared to all other tested constructs, and nearly 50% weaker than dorsal plates in compression and bending 16 …”

mentioning

confidence: 99%

See 3 more Smart Citations

Fixation of Long Oblique and Spiral Metacarpal Shaft Fractures With Intramedullary Screw and Cerclage Wires

Smith,

Sabet,

Luthringer

et al. 2024

Techniques in Orthopaedics

View full text Add to dashboard Cite

Introduction: Long oblique and spiral metacarpal shaft fractures are length-unstable fracture patterns susceptible to malrotation and shortening. We expand the use of intramedullary screw fixation for traditional length-unstable fracture patterns including long oblique and spiral with cerclage wire augmentation. Materials and Methods: Surgical technique of intramedullary screws for long oblique and spiral metacarpal shaft fractures, augmented with cerclage wires, is described. Case series of patients who underwent this technique over a 3-year period from 2 surgeons at a single institution were evaluated. The inclusion criteria included patients who underwent this technique with long oblique or spiral metacarpal shaft fractures. The exclusion criteria included open injuries, and base or neck fractures. Results: A total of 8 patients were included with an average age at surgery 42 years old (range, 25 to 70). Six of the 8 patients achieved full range of motion at the time of final follow-up. One patient had ~5 to 10-degree deficit in both flexion and extension, and the other had 20-degree loss in both flexion and extension. The follow-up averaged 62 days (range, 25 to 144 days). There were no patients with nonunion, malunion, hardware failure, or postoperative fracture subsidence or malrotation. The average time to union was 6.1 weeks (range, 3.5 to 12.4 wks). Conclusions: This hybrid technique expands the use of intramedullary screws to traditional length-unstable fractures including long oblique and spiral patterns. Patients demonstrate return to full range of motion, union approximately in 6 weeks, with minimal complications following this minimally invasive technique.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Fixation of Long Oblique and Spiral Metacarpal Shaft Fractures With Intramedullary Screw and Cerclage Wires

Smith,

Sabet,

Luthringer

et al. 2024

Techniques in Orthopaedics

View full text Add to dashboard Cite

show abstract

“…등 1,[9][10][11] 과 같은 여러 가지 내고정 방법들이 사용되고 있지만 이 들 방법보다 배측 금속판 고정술이 더 나은 결과를 보인다는 보고가 있어 왔다 12 . 그러나 금속판 내고정술이 추가적인 연부 조직 손상을 야기하여 골유합과 기능적 결과에 역 효과를 나 타내고 13,14 , 금속판과 관련된 합병증인 수지 강직(finger stiffness), 건 자극 증상(tendon irritation), 건 파열(tendon rupture)과 같은 문제점을 야기한다고 보고되고 있다 [15][16][17] .…”

unclassified

Outcomes of Unstable Extraarticular Metacarpal Fractures Treated with Low Profile Titanium Plate System

Lee

Chung

Han

et al. 2013

J Korean Soc Surg Hand

View full text Add to dashboard Cite

The purpose of this study was to evaluate clinical results for open reduction and internal fixation of unstable extraarticular metacarpal fractures using low profile titanium plates.Methods: Sixty-two consecutive patients (76 metacarpals) with unstable extraarticular metacarpal fractures who prospectively underwent internal fixation with plating were enrolled. Minimum follow-up was 1 year. There were 48 males and 14 females; average age was 39 years (range, 15-71 years). The location of the fractures was shaft in 65 metacarpals and the type was transverse in 22 cases, oblique in 46 cases, and communited in 8 cases. Of the 62 patients, 11 were open; 9 of these had additional soft tissue injury. The surgical outcome was assessed by clinical and radiographic outcomes and complications.Results: Bone union was successfully achieved in all patients on the average period of 6.4 weeks. The final range of total active motion was excellent for 64 cases, good for 6 cases, fair for 5 cases, and poor for 1 case. Postoperative complications occurred in 9 patients (15 metacarpals). Statistical analysis revealed that patient age, occupation, multiple metacarpal fractures, and soft tissue injury were significantly correlated with incidence of complications at last follow-up. Conclusion:Low profile titanium plating showed the low complication rate and good results in treating unstable extraarticular metacarpal fractures.

show abstract

Transverse and oblique fractures of the diaphysis of the fifth metacarpal: surgical outcomes for antegrade intramedullary pinning versus combined antegrade and retrograde intramedullary pinning

Lazarus

Díaz

Xaxier

et al. 2019

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Internal Fixation of Oblique Metacarpal Fractures

Cited by 24 publications

References 12 publications

Fixation of Long Oblique and Spiral Metacarpal Shaft Fractures With Intramedullary Screw and Cerclage Wires

Fixation of Long Oblique and Spiral Metacarpal Shaft Fractures With Intramedullary Screw and Cerclage Wires

Outcomes of Unstable Extraarticular Metacarpal Fractures Treated with Low Profile Titanium Plate System

Transverse and oblique fractures of the diaphysis of the fifth metacarpal: surgical outcomes for antegrade intramedullary pinning versus combined antegrade and retrograde intramedullary pinning

Contact Info

Product

Resources

About