Intramedullary screw fixation for metacarpal delayed Union: A case report

Okhovatpour, Mohammad Ali; Sadighi, Mehrdad; Sabaghzadeh, Amir; Biglari, Farsad; Jafari Kafiabadi, Meisam; Ebrahimpour, Adel

doi:10.22034/ijos.2024.463541.1087

Intramedullary screw fixation for metacarpal delayed Union: A case report

Document Type : Case Report

Authors

Mohammad Ali Okhovatpour ¹

Mehrdad Sadighi ²

Amir Sabaghzadeh ²

Farsad Biglari ²

meisam jafari kafiabadi ²

Adel Ebrahimpour ²

¹ Assistant professor of Department of Orthopedics, Taleghani Hospital Research Development committee, Medical school, Shahid Beheshti University of medical sciences, Tehran, Iran.

² Department of Orthopedic Surgery, Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

https://doi.org/10.22034/ijos.2024.463541.1087

Abstract

1-Abstract
Metacarpal fractures are common hand injuries that often require surgical intervention for significant displacement or instability. Various fixation methods such as Kirschner wires, plates, external fixators, and intramedullary screws are used, each with potential complications. Understanding the anatomy and biomechanics of the metacarpal is crucial for successful management. We present a case of a 36-year-old man with a second metacarpal fracture following a motorcycle accident. After initial pinning failed, open reduction with internal fixation was performed, later replaced by an intramedullary headless screw. Subsequent physiotherapy led to a successful outcome with normal function and union. Surgical techniques for metacarpal fractures include pinning, plating, and intramedullary devices, each with specific indications and considerations. While pinning is cost-effective and minimally invasive, plating is preferred for certain fracture patterns, and intramedullary devices allow early mobilization. In our case, the intramedullary screw proved effective for delayed Union treatment after previous failures. Larger studies are needed to validate its efficacy and explore potential complications. This case highlights the importance of individualized treatment strategies in complex metacarpal fractures.

Keywords

Fracture

management

Hand injuries

Metacarpal fractures

Open reduction internal fixation

Subjects