Percutaneous flowering technique of intramedullary k- wire fixation for metacarpal shaft fractures- Bouquet/ Foucher Technique

Abstract

Introduction: Metacarpal fractures are one of the most common orthopedic injuries seen in orthopaedic practice. The aim was to study the technique and functional outcome of metacarpal shaft fracture treated with percutaneous flowering (Bouquet Technique/Foucher’s technique) intramedullary fixation of precontoured K wires. Materials and Methods: A nonrandomized, uncontrolled prospective study was performed on 38 patients with 47 metacarpal fractures. They were treated by percutaneous enders type flowering technique (Bouquet) with intramedullary precontoured thin K wires. All patient were screened using inclusion and exclusion criteria and followed up prospectively and assessed the Hand radiologically, clinical and functional outcome, Total active movement, Grip strength, VAS score. Results: Male patients had a significantly higher frequency (68.1%) in comparison to female patients (31.9%) Most common ray affected was 4th and 5th ray followed by 2nd ray and then third ray. 38.3% of fractures were oblique type and 53.2% fractures were transverse, spiral and comminuted being 8.5%. Shaft of metacarpal fracture was maximum affected (74.5%) followed by base (14.9%) and neck (10.6%). 50% patients underwent implant removal in a period of 6 weeks. Conclusion: This method is simple, needs minimal instruments like plier, T handle, k wire cutter bender and is cost effective, and well tolerated and with added advantage of early bone healing with good functional outcome. Being percutaneous technique there is no operative incision scar or need of anaesthesia required for removal of k wires after the treatment period. Keywords: Bouquet technique of Precontoured, Intramedullary K wire flowering fixation, Metacarpal fracture.