Preoperative – (a) Posteroanterior and (b) lateral radiographs of a patient's right hand, demonstrating that there were the shaft fractures of the fourth and fifth metacarpi with dorsal angulation. We undertook a descriptive case series of patients who sustained fourth and/or fifth metacarpal shaft fractures and underwent fixation with bioabsorbable intramedullary rods and investigated their clinical outcomes including bone union time, range of motion (ROM) for the involved fingers, grip strength, as well as the potential implications for the bioabsorbable implants. To avoid the irritation of tendons and soft tissues as well as hardware-related problems, we designed an intramedullary fixation with bioabsorbable rods for the treatment of the metacarpal shaft fractures. Compared with conventional hardware, bioabsorbable implants are thought to provide gradual load transfer to the healing tissue, reduced need for hardware removal and radiolucency, which facilitates postoperative radiological evaluation. With open reduction and internal fixation, the hardware may need to be removed at a later date, especially if the patient complains of hardware-related pain.īioabsorbable implants are being used with increasing frequency in the treatment of small bone fractures or fractures involving the joint surface. However, even with K-wires, there can still be hardware-associated complications such as wire track infection, soft tissue irritation, and tendon adhesion or rupture. The benefit of the plate and screws fixation is that it provides an extremely rigid fixation while the K-wire fixation is the least invasive method. Although some of these fractures can be treated conservatively, grossly displaced and comminuted fractures should be surgically corrected either with closed reduction and stabilization with percutaneous Kirschner wires (K-wires) or open reduction internal fixation with plate and screws. In these fractures, angulation deformity is frequently found. Fourth and fifth metacarpal shaft fractures are one of the most common hand injuries encountered in clinical practice.
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