Application of self-prepared Kirschner wire retractor reduction and internal fixation through ulnar dorsal approach for the treatment of Bennett fractures

Abstract

Objective To explore the clinical efficacy of self-prepared Kirschner wire retractor reduction and internal fixation through ulnar dorsal approach in the treatment of Bennett fractures. Methods From July 2014 to February 2018, 13 patients with Bennett fractures were treated. The first carpometacarpal ulnar dorsal approach was designed to expose the fracture and articular surface. The reduction was performed using self-prepared Kirschner wire retractor, and then the fracture was fixed with Kirschner wires. Early functional exercise was performed after the operation, and Kirschner wire was removed after 4 to 6 weeks. Results All the patients were follow-up for 6 to 24 months postoperatively with an average of 14.6 months. All the incisions achieved primary healing. Bone healing was achieved in all the patients, and the pre-traumatic activity was restored 10 weeks after the operation. The VAS score ranged from 0 to 3 with an average of 1.46. The function of affected finger was evaluated by total active motion (TAM) assessment and the results were rated as excellent in 11 cases and good in 2 cases. One patient had redness and swelling in the needle track, while the other patients had no complications such as infection of the needle track, irritation of surrounding soft tissue, loosening of Kirschner needle and re-dislocation of joint. Conclusion The method of reduction and fixation of Bennett fractures through ulnar dorsal approach using self-prepared Kirschner wire retractor proves to be simple and reliable, which is worthy of clinical application. Key words: Fractures,bone; Treatment outcome; Internal fixator; Reduction