gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Cerclage wiring and its modification for long oblique/spiral fracture of the metacarpal shaft

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  • presenting/speaker Soya Nagao - Itabashi Medical Association Hospital, Department of Orthopaedics, Tokyo, Japan
  • Koji Tanimoto - Nihon University Hospital, Department of Orthopaedic Surgery, Tokyo, Japan
  • Hisataka Takesako - Nihon University Hospital, Department of Orthopaedic Surgery, Tokyo, Japan
  • Kana Kataoka - Nihon University Hospital, Department of Orthopaedic Surgery, Tokyo, Japan
  • Yoshiaki Tomizuka - Nihon University Hospital, Department of Orthopaedic Surgery, Tokyo, Japan
  • Masahiro Nagaoka - Nihon University Hospital, Department of Orthopaedic Surgery, Tokyo, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1877

doi: 10.3205/19ifssh0120, urn:nbn:de:0183-19ifssh01204

Veröffentlicht: 6. Februar 2020

© 2020 Nagao et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

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Objectives/Interrogation: It is not so easy to perform lag screw technique for long oblique/spiral fracture of the metacarpal shaft because of difficulty to place the screws, measure correct length of the screws and develop a crack. The purpose of this study is to reveal the postoperative outcome of cerclage wiring procedure reported by Gropper and Al-Qattan, and introduce our modification of this procedure.

Methods: Sixteen metacarpals in 15 hands in 14 cases (12 males and 2 females) were treated for long oblique/spiral metacarpal shaft fracture. Initial 7 metacarpals were immobilized by original 2 or 3 single looped cerclage stainless-steel wires of nearly 0.5mm in diameter. Next 4 metacarpals were stabilized by double looped cerclage sutures with #2-0 FiberWire to avoid the removal. Recent 5 metacarpals were treated by double looped cerclage wires to improve the stability. Affected hands were immobilized with intrinsic plus position by plaster splint for within 2 weeks postoperatively. Postoperative outcome and complications were investigated in all cases.

Results and Conclusions: Bone union was achieved without rotational malunion and shortening in all 16 cases. However, wire aberrance to the fracture site was occurred in an initial metacarpal, and mild limitation of the affected metacarpophalangeal joint in an oldest (77 years) initial case. Also, constriction of the cortex was appeared in 3 metacarpals treated by cerclage sutures. No complications were seen in all recent metacarpals treated by double looped cerclage wires.

Cerclage wiring procedure is easy, cost-effective and reliable compared with other procedures. Double looped wire is more stable and reliable than single looped wire. We are going to continue performing double looped cerclage wiring technique for long oblique/spiral metacarpal shaft fractures.