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Operative Orthopädie und Traumatologie

, Volume 8, Issue 3, pp 185–190 | Cite as

Intramedulläre Schienung von dislozierten Mittelhandfrakturen

  • Christian Müller
  • Heinz Helge Schauwecker
Article

Schlüsselwörter

Frakturen Mittelhandknochen Intramedulläre Schienung 

Intramedullary pinning of displaced metacarpal fractures

Summary

Goal of Surgery

Maintenance of reduction of displaced metacarpal fractures assuring return to normal hand function.

Indications

Absolute: Fresh metacarpal fractures at the middle and distal third.

Relative: Metacarpal fractures at the proximal third.

Contraindications

Metacarpal fractures with articular involvement.

Malunited metacarpal fractures.

Positioning and Anaesthesia

Supine.

Plexus anaesthesia.

No tourniquet.

Surgical Technique

Short longitudinal incision over the base of the metacarpus.

Oblique perforation of the cortex using an awl; opening of the medullary canal.

Introduction of the blunt end of a 1.4 mm Kirschner wire and advancement to the fracture site.

Reduction of the fracture under image identification.

Further advancement of the Kirschner wire and impaction in the subchondral bone of the metacarpal head.

Postoperative Management

Palmar forearm slab for a few days. Active hand and finger exercises.

Wire removal after 6 to 8 weeks. Full use after radiologic evidence of bony consolidation.

Possible Complications

Injury of skin nerves.

Distraction of the fracture site, delayed healing, nonunion.

Rotational malposition.

Infection.

Results

All 55 pinned metacarpal fractures (50 men, 5 women, mean age 31 years) healed without malunion. All patients obtained a full range of motion.

Three complications which had no influence on the end result: 1 superficial infection, 1 loss of reduction which was treated successfully by a revision, and 1 proximal wire migration.

Key Words

Fractures Metacarpal bones Intramedullary pinning 

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Literatur

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Copyright information

© Urban & Vogel 1996

Authors and Affiliations

  • Christian Müller
    • 1
  • Heinz Helge Schauwecker
    • 1
  1. 1.Klinik für Unfall-, Hand- und WiederherstellungschirurgieDRK Kliniken WestendBerlin

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