The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Dec 2008
The use of a combination of cerclage and unicortical interosseous loop dental wires for long oblique/spiral metacarpal shaft fractures.
A literature review of metacarpal fracture fixation techniques revealed that the use of a combination of interosseous and cerclage dental loop wires has not been previously described. In this report, we review the results of 24 patients with long oblique/spiral metacarpal shaft fractures of the fingers treated by this combined technique of internal fixation, followed by immediate postoperative finger mobilisation in a wrist splint. ⋯ Complications included one case of CRPS Type 1 resulting in mild stiffness and all four women complained of the hyperpigmentation of the dorsal hand scars. The advantages of dental wire fixation were discussed and compared to those of lag screws.
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Percutaneous screw fixation of undisplaced fractures of the scaphoid waist has gained popularity but remains technically demanding. This study describes a transtrapezial modification of the volar percutaneous technique and reports the results in 41 patients. The patients were evaluated at a mean of 36 months (range 14-68 months) after surgery. ⋯ Functional ranges of wrist motion and grip strength were achieved in all patients. Radiographs showed accurate central placement of the screw in all patients and no degenerative changes were seen at the scaphotrapezial joint. In three patients, the screw was removed because it was prominent at the scaphotrapezial joint.