Percutaneous Kirschner wire fixation combined with mini external fixation for treatment of the fifth metacarpal base fractures

Abstract

Objective To evaluate the clinical outcomes of the minimally invasive technique of percutaneous Kirschner wire fixation combined with mini external fixation in the treatment of the fifth metacarpal base fractures. Methods Eleven patients underwent this minimally invasive technique were enrolled and followed up. All of the patients were diagnosed as the fifth metacarpal base fractures according to the typical X-ray manifestation. In this modified procedure, the fracture was reduced by mini external fixation traction and manual manipulation, and the fifth metacarpal was then fixed to the fourth and third metacarpal by 2 percutaneous Kirschner wires. All the fixation devices were removed 6 weeks postoperatively. The mean follow-up period was 15.7 weeks. X-ray, VAS score, range of motion (ROM) as well as the grip strength of the affected hand were checked for all the patients and the TAM scoring system was used for the function evaluation. Results All the 11 patients achieved satisfied union for the fifth metacarpal base fractures without wire tract infection or screw rod loosening and break. The average postoperative VAS score was 1.13. The patients achieved an averaged 89.3% grip strength compared to the healthy side. According to the TAM scoring system, the results were excellent in 6 cases, good in 4 cases and fair in 1 case. Conclusion The minimally invasive technique of percutaneous Kirschner wire fixation combined with mini external fixation appears to be an effective and safe procedure for treatment of the fifth metacarpal base fractures. Key words: Fractures,bone; External fixators; Fifth metacarpal base; Minimally invasive technique