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Fractures and Dislocations of hand wrist forearm elbow upper arm and shoulder

Percutaneous Flexible Intramedullary Nailing Of Metacarpal And Phalangeal Fractures

Poster Board Number: PE212
Location: Hall E
Moscone Convention Center

Hand & Wrist
Jorge L. Orbay, MD Miami FL
(D - Hand Innovations)
Alejandro Badia, MD Miami FL
Igor R. Indriago, MD Miami FL
Roger K. Khouri, MD Miami FL

Purpose: Metacarpal fractures are common but consensus on the best mode of treatment has not been established. For severely displaced fractures, open reduction and internal fixation with plates or screws is commonly performed. Unfortunately, extensor tendon adhesions and/or unsightly scars frequently follow this form of treatment. Flexible Intramedullary nailing of these fractures, with multiple small pins, has been described. The method is not popular because it is technically demanding. We have performed flexible Intramedullary nailing of metacarpal fractures utilizing a single, large nail and a simplified method of percutaneous insertion. Methods: We treat extra-articular metacarpal and phalangeal fractures with percutaneously inserted anterograde nails. Our method utilizes flexible nails (.062 and .045) and closed fluoroscopically assisted reduction. Metacarpal Phalangeal joint flexion block splinting is used for four weeks and the nails are routinely removed in the office after fracture healing. Results: We have collected 140 patients with metacarpal or phalangeal fractures treated with this method. We have 119 metacarpal fractures and 41 phalangeal. All fractures healed. Patients have no rotational deformities. All patients returned to previous occupation. Metacarpal fractures recovered full range of motion. Phalangeal fractures presented more serious challenge. Average total active motion for phalangeal fractures was 210°. Complications are infrequent and can be treated successfully. Conclusion and Significance: Our experience with this technique is very favorable as it avoids exposure of the fracture, dissection around the extensor mechanism and scar problems. It obtains excellent functional results and has a low complication rate.
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Wednesday, February 28 10:00 AM - 7:00 PM
Thursday, March 1 through Saturday, March 3 7:30 AM - 5:00 PM
Sunday, March 4 7:30 AM - 12:30 PM
The principal exhibitor will be available from 12:00 Noon to 3:00 PM to discuss the exhibit and answer questions regarding the poster.
Cameras may be used in the Poster Exhibit area.

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