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Fracture fifth metacarpal

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https://www.readbyqxmd.com/read/29410077/simplified-internal-fixation-of-fifth-metacarpal-neck-fractures
#1
L Amsallem, J Pierrart, T Bihel, J Sekri, T Lafosse, E Masmejean, D Delgrande
BACKGROUND: Fifth metacarpal neck fractures (boxer's fractures) are common injuries that contribute 20% of all hand fractures. Divergent percutaneous pinning (bouquet fixation) as described by Foucher has gained popularity but is challenging and at times arduous, as it requires the insertion of several slender K-wires into a narrow medullary canal. Here, we report on a simplified technique in which a single thick K-wire is inserted. TECHNIQUE: An 18/10 K-wire is bent at one end then mounted on a drill chuck...
January 31, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29369103/antegrade-intramedullary-pinning-in-subacute-fifth-metacarpal-neck-fracture-after-failed-conservative-treatment-a-prospective-comparative-study-with-acute-fracture
#2
Soo Min Cha, Hyun Dae Shin
PURPOSE: The purposes of this study were to evaluate the efficacy of antegrade intramedullary pinning performed for neck fractures with angulations of over 30 degrees after failed conservative treatment during the subacute phase and to compare the radiologic and clinical results with those of acute fractures with angulations of over 30 degrees treated via the same procedure. METHODS: Seventy-three patients with a fifth metacarpal neck fracture were admitted to our institute between January 2010 and April 2015...
January 24, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29089198/dynamic-ultrasound-imaging-for-the-assessment-of-extensor-tendon-adhesion-after-fifth-metacarpal-intraarticular-head-fracture-a-case-report
#3
Tugce Ozekli Misirlioglu, Hakan Ozben
STUDY DESIGN: Case report. INTRODUCTION: Development of extensor tendon adhesions is a common complication after intra-articular metacarpal head fracture. Whenever these adhesions cannot be mobilized by rehabilitation, tenolysis should be considered. However, the decision for tenolysis is often delayed. When the rehabilitation program comes to a plateau and clinical examination may not be sufficient to find out the cause, dynamic ultrasound (US) can show where the gliding mechanism is disrupted and help clinicians to give an accurate decision for determining the next steps...
October 28, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/29062215/transverse-pinning-versus-intramedullary-pinning-in-fifth-metacarpal-s-neck-fractures-a-randomized-controlled-study-with-patient-reported-outcome
#4
Sherif Galal, Wael Safwat
INTRODUCTION: The 5th metacarpal fractures accounts for 38% of all hand fractures given that the neck is the weakest point in metacarpals, so neck fracture is the most common metacarpal fracture. Surgical fixation is also advocated for such fractures to prevent mal-rotation of the little finger which will lead to fingers overlap in a clenched fist. Various methods are available for fixation of such fractures, like intramedullary & transverse pinning. There are very few reports in the literature comparing both techniques...
October 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28980482/the-utility-of-plain-films-for-nonoperative-fifth-metacarpal-fractures-are-follow-up-radiographs-necessary
#5
Nathanael Heckmann, Marie N Dusch, William C Pannell, Michael Bauschard, Ram K Alluri, Lakshmanan Sivasundaram, Alidad Ghiassi
BACKGROUND: Fifth metacarpal fractures are often treated nonoperatively with serial radiographs; however, the utility of these radiographs in altering clinical management has not been investigated. We hypothesize that follow-up plain films will not alter clinical management and are therefore unnecessary for most patients. METHODS: Between 2007 and 2014, patients with a fifth metacarpal fracture at our level I trauma center were retrospectively reviewed. Patients with inadequate documentation or imaging, ipsilateral upper extremity injuries, or who underwent initial surgical fixation were excluded...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28970518/three-screw-versus-two-screw-fixation-of-distal-fragment-in-fifth-metacarpal-neck-fractures-stabilized-with-locking-plate
#6
Hongyi Zhu, Bingbo Bao, Xianyou Zheng
Fifth metacarpal neck fracture commonly requires open reduction and internal fixation. Locking plate was widely adopted in the treatment of fifth metacarpal neck fracture as first-line choice for fixation. Patients with fifth metacarpal neck fracture receiving locking plate fixation were included for analysis. Features of internal fixation including number of distal and proximal locking screws, diameter of the screws and usage of lag screws were recorded. Clinical and radiographic outcomes included final volar angulation, grip strength, Michigan Hand Outcomes Questionnaire (MHQ) and range of motion (ROM) of fifth metacarpophalangeal joint...
October 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28933198/iatrogenic-injuries-in-percutaneous-pinning-techniques-for-fifth-metacarpal-neck-fractures
#7
Sheriff D Akinleye, Garret Garofolo-Gonzalez, Maya Deza Culbertson, Jack Choueka
BACKGROUND: There is little information regarding anatomic structures at risk during closed percutaneous treatment of fifth metacarpal neck fractures. This study evaluates a variety of common percutaneous techniques with the hypothesis that each approach presents unique risks to tendons and neurovascular structures. METHODS: Seven cadaveric hands were used for this study. The senior author, a board-certified hand surgeon with more than 20 years of experience, used a mini-C arm to pass 1...
September 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28840672/-minimal-invasive-osteosynthesis-with-cannulated-screws-in-metacarpal-fractures
#8
R Romo-Rodríguez, C Arroyo-Berezowsky
Metacarpal fractures comprise 18 to 44% of hand fractures. Fractures from the second to the fifth metacarpals are 88% of the metacarpal fractures and fractures of the fifth metacarpals are the most common. Fractures of the neck of the fifth metacarpal are about 20% of all the hand fractures. Most of these fractures can be treated conservatively with good functional results. However, for those neck and shaft unstable fractures that need surgical treatment, there is no gold standard for osteosynthesis. Recently, there have been reports of minimally invasive osteosynthesis using headless retrograde intramedullary cannulated screws with good functional results...
March 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28718330/anatomic-assessment-of-k-wire-trajectory-for-transverse-percutaneous-fixation-of-small-finger-metacarpal-fractures-a-cadaveric-study
#9
Louis C Grandizio, Amy Speeckaert, Zach Kozick, Joel C Klena
BACKGROUND: The purpose of this cadaveric study is to evaluate the trajectory of percutaneous transverse Kirschner wire (K-wire) placement for fifth metacarpal fractures relative to the sagittal profile of the fifth metacarpal in order to develop a targeting strategy for the treatment of fifth metacarpal fractures. METHODS: Using 12 unmatched fresh human upper limbs, we evaluated the trajectory of percutaneous transverse K-wire placement relative to the sagittal profile of the fifth metacarpal in order to develop a targeting strategy for treatment of fifth metacarpal fractures...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28718309/intra-articular-fracture-of-the-base-of-the-first-metacarpal-bone-treatment-through-a-volar-approach
#10
Violeta Levy, Marcelo Mazzola, Martín Gonzalez
BACKGROUND: Management of Bennett fractures has been controversial. Early reports supported closed reduction and casting with or without percutaneous pinning. Later, open reduction and internal fixation was advocated. The purpose of this article is to assess the surgical treatment using a direct volar approach. METHODS: Between March 2008 and December 2014, 21 patients with intra-articular first metacarpal fractures displaced more than 1 mm were operated on using a direct volar approach...
January 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28716512/results-of-the-dubert-procedure-for-chronic-painful-fracture-dislocations-of-the-fifth-carpometacarpal-joint-a-report-of-6-cases
#11
N Meraghni, G Bacle, E Marteau, Y Bouju, J Laulan
Carpometacarpal (CMC) fracture-dislocations of the fifth ray are common. For chronic injuries, Dubert proposed combining resection arthroplasty of the base of the fifth metacarpal (M5) with synostosis with the fourth metacarpal (M4). Our aim was to evaluate the results of this procedure. Between 1994 and 2014, 7 men and 1 woman with an average age of 36 years (range, 27 to 45) were operated on. The right hand was involved in 6 of the 8 cases. All patients had symptomatic osteoarthritis secondary to isolated articular malunion and subluxation of the 5th CMC joint...
October 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28587371/outcome-of-antegrade-intramedullary-fixation-for-juvenile-fifth-metacarpal-neck-fracture-with-titanium-elastic-nail
#12
Kaiying Shen, Yunlan Xu, Dan Cao, Zhigang Wang, Haiqing Cai
The purpose of the current study was to assess the outcome of antegrade intramedullary fixation with titanium elastic nail (TEN) in displaced fifth metacarpal neck fractures. The present study included 69 consecutive juvenile patients with displaced fifth metacarpal fractures. The head-shaft angle of the fifth metacarpal and range of motion (ROM) of the metacarpophalangeal (MCP) joint were evaluated. A disabilities of the arm, shoulder and hand (DASH) questionnaire was used to assess upper arm function. The head-shaft angle of the affected side was significantly improved postoperatively (P<0...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28577350/treatment-of-fifth-metacarpal-neck-fractures-with-antegrade-single-elastic-intramedullary-nailing
#13
Yuanshi She, Youjia Xu
BACKGROUND: The aim of this study was to investigate clinical outcomes of fifth metacarpal neck fractures using antegrade single elastic nail and to explore ideal puncture point to avoid iatrogenic ulnar nerve injury. METHODS: A single elastic nail with suitable diameter was used in 27 cases of fifth metacarpal neck fractures with dorsal angulation over 45°. An initial entry point was perforated at the ulnar-dorsal base of the metacarpal. The nail was inserted in an antegrade approach...
June 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28551317/elastic-retrograde-intramedullary-percutaneous-pinning-for-fifth-metacarpal-neck-fractures-a-series-of-32-patients
#14
M-A Poumellec, N Dreant
The aim of our study was to evaluate an original surgical technique for the treatment of fifth metacarpal neck fractures: elastic retrograde intramedullary percutaneous pinning (ERIPP). From January 2014 to January 2016, patients with a fifth metacarpal neck fracture with greater than 30° volar displacement and/or clinodactyly were included. All patients underwent an ERIPP procedure. With this technique, K-wires are used as joysticks to assist reduction when the Jahss maneuver is insufficient. Clinical evaluation incorporated the DASH score, range of motion and grip strength at 3months...
September 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28467335/fifth-metacarpal-neck-fractures-fixation-with-antegrade-locked-flexible-intramedullary-nailing
#15
Francesco Pogliacomi, Elisabetta Mijno, Alesssio Pedrazzini, Silvio Tocco, Massimo Tonani, Francesco Ceccarelli, Enrico Vaienti
BACKGROUND: Fifth metacarpal neck fractures (commonly named "boxer's fractures") are the most common metacarpal injuries and usually affect young active people. These lesions are mainly treated conservatively. Their surgical management, if indicated, is still a matter of debate. Different procedures have been described. The aim of this study was to evaluate the outcomes of 18 boxer's fractures which were synthesized with antegrade locked flexible intramedullary nailing. MATERIALS AND METHODS: All patients, at a mean follow-up of 45 months, were clinically evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score and the Patient Rated Wrist/Hand Evaluation (PRWHE)...
April 28, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28455539/morphological-and-topographical-anatomy-of-nutrient-foramens-in-human-metacarpals-and-their-surgical-importance
#16
Anjali Singla, Gurdeep Kalsi, Nazir Masih, Tulika Gupta, Mahesh Sharma
PURPOSE: Trauma to the hand is extremely common, often resulting in metacarpal fractures and dislocations. The surgical intervention may be required for restoration of function and appearance. The preoperative, topographical knowledge of the nutrient foramens is valuable in such operative procedures to preserve the circulation for healing and good postoperative results. METHODS: The topographic and morphometric analysis of 250 non-pathological metacarpals (fifty each from first to fifth) was performed and the foraminal index of each metacarpal was evaluated...
November 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28378776/locking-plate-alone-versus-in-combination-with-two-crossed-kirschner-wires-for-fifth-metacarpal-neck-fracture
#17
Hongyi Zhu, Zhengyu Xu, Haifeng Wei, Xianyou Zheng
Fracture of fifth metacarpal neck commonly requires open reduction and internal fixation. However, the current methods of internal fixation in fifth metacarpal neck fractures remain unsatisfactory. Patients with fractures of fifth metacarpal neck received open reduction and internal fixation with either locking plate in combination with two crossed Kirschner wires (K-wires) or locking plate alone were evaluated for the clinical outcomes. Clinical outcomes included grip strength, Michigan hand outcomes questionnaire (MHQ), final angulation and range of motion (ROM) one year after treatment...
April 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28368901/fortuitous-diagnosis-of-preexisting-neuropathy-during-ultrasound-guided-regional-anesthesia-performance-a-case-report
#18
Philippe Marty, Bertrand Basset, Constance Marquis, Medhi Merouani, Olivier Rontes, Alain Delbos
Ultrasound-guided regional anesthesia requires the anesthesia provider to interpret new information. This article reports on the case of a 38-year-old man scheduled for a fifth metacarpal fracture repair. Ultrasound nerve examination revealed abnormal pathology of the axillary brachial plexus consisting of an increased volume of the terminal nerves of the brachial plexus. Ultrasound scanning initiated the subsequent diagnosis of multifocal motor neuropathy. Regional anesthesia was abandoned in favor of general anesthesia...
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28251281/total-wrist-arthrodesis-for-septic-wrist-arthritis-and-loss-of-the-bony-carpus-following-percutaneous-pinning-of-the-fifth-carpometacarpal-joint-a-case-report
#19
C Deml, S A Euler, G Schmidle, S Erhart, M Gabl, R Arora
We report on a patient who developed septic wrist arthritis with destruction of the entire carpus due to osteomyelitis following percutaneous pinning of a fifth metacarpal base fracture. Arthrodesis was performed using a 6 cm vascularized iliac bone graft. This case report may sharpen the surgeon's awareness of risks in orthopedic surgeries, even though the procedure seems to be rather simple and the patient is young and seems to be healthy.
June 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27804078/assessment-of-the-2d-4d-ratio-in-aggression-related-injuries-in-children-attending-a-paediatric-emergency-department
#20
D E O'Briain, P H Dawson, J C Kelly, P Connolly
BACKGROUND: The 2D:4D ratio is a sexually dimorphic trait. A lower ratio is correlated with sporting prowess, successful financial trading, risk taking behaviour, aggression, and aggression-related injuries, such as the fifth metacarpal fractures. AIMS: We aimed to assess if the ratio correlates to skeletally immature patient aggression. METHODS: Radiology reports were searched for the terms "5th metacarpal" or "boxer". Of 537 X-rays, 142 had fractures...
May 2017: Irish Journal of Medical Science
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