Closed reduction and percutaneous K-wire fixation for treatment of periarticular fractures at the metacarpophalangeal joint

Abstract

Objective To assess the clinical outcomes of treating periartieular fractures of the metacarpophalangeal ioint with closed reduelion and percutaneous K-wire fixation.Methods Since 2005,17cases of metacarpal neck fractures or proximal phalanx base fraetures were treated by closed reduction and percutaneous K-wire fixation under fluoroscopic monitoring.There were 11 simple fractures including 7 at the metacarpal head or neck and 4 at the proximal phalanx base.Six cases had fractures involving multiple digits.There were 3 cases of metacarpal neck fractures at more than 2 digits,1 case of proximal phalanx base fractures involving digit 2 to 5,1 case of proximal phalanx base fractures of diglt 2 to 4,and 1 case of metacarpal neck fracture of digit 5 and proximal phalanx base fracture ofdigit 4.All the fracmres were dose fractures.Four cases were operated the day of the injury,12 cases at 5 days after the injury,and 1 case at 11 days after the injury.Gtst was removed 2 to 3 weeks p06toperatively.K-wires were removed 4 weeks poetoperatively.Results Postoperative X-rays showed good reduction in all cases.Follow up period ranged from 6 to 9 months.Au the fractures were well healed.The hand function was evaluated by TAM system which was graded as excellent in 13 cases and good in 4 cases.Conclusion Close reduction and percutaneous pinning is nil ideal way to treat periarticular fractures of the metacarpophalangeal joint.It is minimnally invasive,simple and effective. Key words: Fractures,closed; Metacarpal bones; Finger phalanges; Fracture fixation,internal; Close reduction