19. OUTCOMES OF HAND FRACTURE TREATMENTS BY TRANSVERSE PERCUTANEOUS K-WIRE FIXATION
Main Article Content
Abstract
Background: Hand fractures are relatively common, accounting for about 10% of all fractures, of which more than 70% are in working-age patients. Hand fractures can be treated conservatively or surgically, with a variety of fixation from closed surgery with K-wire or external fixation or open surgery with plate fixation. Minimally invasive surgery by transverse percutaneous k-wire fixation brings many benefits, however currently in Vietnam there are no reports on the results of treatment with this method..
Objective: We aim to research clinical features and radiographic characteristics as well as evaluate the outcomes of metacarpal fractures treatment by transverse percutaneous K-wire fixation at Pleiku City General Hospital.
Methods: A cross-sectional study was conducted on 11 patients who had metacarpal fractures treatment by transverse percutaneous K-wire from January 2021 to September 2022 at Pleiku City General Hospital.
Results: 11 patients with 14 metacarpal fractures were treated with K-wire. The majority of patients had 1 bone fracture (72.7%), right arm fracture (81.8%), and closed fracture (81.8%), metatarsal shaft fractures (57.1%). Surgery time is quite fast (average 30 minutes). Most metacarpals heal after 2 months. Delayed healing occurred in 1 patient at a rate of 3.23%. 1 case with infected pin site among the total number of people surveyed.
Conclusions: Through the research, we realized transverse percutaneous K-wire fixation in treating metacarpal fractures helps immobilize the fracture well, minimally invasive surgery, thus limiting pain and blood loss, allowing early mobilization, which is the key to achieving results, good function, avoiding joint stiffness as well as reduced or loss of hand function.
Article Details
Keywords
Metacarpal fractures, Kirschner wire, minimally invasive surgery.
References
gãy xương bàn ngón tay bằng nẹp vít tại Bệnh
viện đại học Y Hà Nội, Y học thực hành 2013,
884(10), tr. 8-9, 2013
[2] Witroet, Techniques dosteo synthese des
fractures diaphysaires de jambe-EMC Techn,
OP, 44871, pp. 1-9, 1981.
[3] Nam Yong Choi, M.D., Hyun Seok Song,
M.D, Treatment of Metacarpal Fractures using
Transverse Kirschner-wire Fixation, J Korean
Orthop Assoc 2007; 42: 608-615
[4] Louis CG et al., Anatomic Assessment of
K-Wire Trajectory for Transverse Percutaneous
Fixation of Small Finger Metacarpal Fractures A
Cadaveric Study, 2018, Vol. 13(1) 86–89.
[5] Suk-Ho Moon et al., The Efficacy of Transverse
Fixation and Early Exercise in the Treatment of
Fourth Metacarpal Bone Fractures, Arch Plast
Surg 2016; 43:189196
[6] A.P.A. Greeven et al., Closed reduction
intermetacarpal Kirschner wire fixation in the
treatment of unstable fractures of the base of the
first metacarpal, Injury, Int. J. Care Injured 43
(2012), 246–251.
[7] Phan Minh Trí, Đỗ Phước Hùng, Điều trị gãy kín
thân xương bàn các ngón tay dài bằng phương
pháp xuyên kim kirschner dưới màn tăng sáng,
Y Học TP. Hồ Chí Minh, 14(1), tr. 91-93, 2012.
[8] Mai Đức Dũng và cs, Kết quả điều trị gãy xương
bàn ngón tay bằng nẹp vít khóa tại bệnh viện
trung ương thái nguyên, Trường Đại học Y Dược
- ĐH Thái Nguyên, Bệnh viện Trung ương Thái
Nguyên, 2012.
[9] James BM et al., Mechanical analysis of
Kirschner wire fixation in a phalangeal model,
the jounal of hand surgery, 1978.
[10] Sameer IS et al., External fixation of metacarpal
and phalangeal fractures, the journal of hand
surgery, 1991
[11] Ashok SP e al., Fixation of closed metacarpal
shaft fractures Transverse K-wires in 22 cases,
Acta orthop Scand 1994; 65 (4): 427-429
[12] T.C.Wong, F.K.ip, S.H. yeung, Comparison
between percutaneous transverse fixation and
intramedullary K-wires in treating closed
fractures of the metacarpal neck of the little
finger, the journal of hand surgery vol. 31b no.
1 February 2006.
[13] Nam Yong Choi, M.D., Hyun Seok Song,
M.D, Treatment of Metacarpal Fractures using
Transverse Kirschner-wire Fixation, J Korean
Orthop Assoc 2007; 42: 608-615
[14] Sheriff DA et al., Iatrogenic Injuries in
Percutaneous Pinning Techniques for Fifth
Metacarpal Neck Fractures, HAND2019, Vol.
14(3) 386–392
[15] Yung-Cheng Chiu et al., New fixation approach
for transverse metacarpal neck fracture a
biomechanical study, Journal of Orthopaedic
Surgery and Research (2018) 13:183
[16] V. Potenza, R. Caterini, Fractures of the neck of
the fifth metacarpal bone. Medium-term results
in28 cases treated by percutaneous transverse
pinning, Injury, Int. J. Care Injured 43 (2012),
242–245.