• Seung Hwan Rhee, Sang Ki Lee, Sang Lim Lee, Jihyeung Kim, Goo Hyun Baek, and Young Ho Lee.
• Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea.
• Plast. Reconstr. Surg. 2012 Mar 1; 129 (3): 694-703.

BackgroundThe purpose of this prospective multicenter study was to assess the clinical and radiographic outcome of a newly devised technique of retrograde intramedullary fixation with multiple Kirschner wires in metacarpal neck and shaft fractures.MethodsBetween May of 2002 and June of 2007, a total of 121 metacarpal fractures in 105 patients that were treated with the authors' modified intramedullary Kirschner wire fixation technique were included in this study. The average follow-up period was 10 months. The surgical outcome was assessed by clinical and radiographic data.ResultsThe average range of motion in the metacarpophalangeal joint of the injured side was not significantly different from that of the uninjured side. There was no case of residual rotational deformity postoperatively, and the average Disabilities of the Arm, Shoulder and Hand questionnaire score was 8.5 (range, 0 to 41). Average dorsal apex angulation and average shortening were reduced significantly from 39.0 degrees and 3.1 mm, to 9.7 degrees and 0.0 mm, respectively, in neck fractures; and from 29.5 degrees and 3.0 mm, to 7.0 degrees and -0.1 mm in shaft fractures, respectively. Average time to union was 5.6 weeks, and there were no cases of nonunion.ConclusionModified retrograde intramedullary fixation with multiple Kirschner wires is a straightforward and reliable technique that successfully resulted in good functional and cosmetic results in addition to excellent bone healing.Clinical Question/Level Of EvidenceTherapeutic, IV.

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