International Surgery Journal | January 2021 | Vol 8 | Issue 1 Page 48
International Surgery Journal
Malik A et al. Int Surg J. 2021 Jan;8(1):48-53
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Original Research Article
Circumosseous wire fixation for metacarpal fractures: an old
method revisited
Anil Malik
1
*, Parvesh Malik
1
, Vijay Kumar Pandey
1
, Dev Jyoti Sharma
1
, Kumar Pushkar
2
INTRODUCTION
Metacarpal fractures comprise around 18-44% of all hand
fractures and fifth metacarpal fracture being most
commonly involved.
1,2
Metacarpal fractures may be open
or closed, intra or extra-articular. Fracture lines may be
oblique, transverse, spiral or comminuted.
3
Minimally displaced, with no rotational deformity
metacarpal fractures are generally managed
conservatively.4Simple fractures with significant
rotational deformity or displacement are managed with
various fixation methods like percutaneous K-wire
fixation (longitudinal or transverse) or one of the various
open fixation methods available such as plates and screws
,lag screws, K-wires, interosseous or circumosseous
dental wires , combinationof K-wires and dental loop
wires.
4-14
Complex metacarpal fractures are generally
managed with external fixationor rigid internal
fixation.
15,16
Gropper et al about 36 years ago had described a simple
technique using dental wires in circumosseous fixation
for spiral and oblique fractures of metacarpal shaft. This
technique did not gain popularity as authors believed that
bone always had to be scored to prevent wire from
migrating and this weakened the already fractured bone.
Secondly it was believed that fixation was not rigid.
In the present study 128 cases of metacarpal shaft
fractures were treated with one of the methods K-wire
fixation, plates and screws, circumosseous dental wiring.
The results of all three methods were compared for
fracture healing and functional outcome.
ABSTRACT
Background: Different methods are in use for fixation of metacarpal fractures. Krischener wire and titanium
miniplates are most commonly used methods. Both these methods require special & sophisticated instruments. In this
study, we have used a dental wire in circumosseous fashion to fix the metacarpal fractures.
Methods: In the study, we included all the fracture of metacarpals with operative indication. K-wire, minilplate
system and circumosseous dental wire methods were used randomly.
Results: The results were compared in term of immediate post-operative complications & functional recovery in form
of ability of fist formation at 06 weeks. All the three methods were found comparable, in fact in this study the results
of fractures treated with circumosseous wiring were appreciable and significantly better.
Conclusions: Circumossoeus use of dental wire can be an alternate method of metacarpal fracture fixation.
Keywords: Metacarpal, Fracture, Circumossoeus wiring
1
Department of Plastic Surgery, Command Hospital, Chandimandir, Haryana, India
2
Department of Community Medicine, Command Hospital, Wanowrie, Pune, Maharashtra, India
Received: 01 December 2020
Revised: 15 December 2020
Accepted: 16 December 2020
*Correspondence:
Dr. Anil Malik,
E-mail: anilmalik1309@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2349-2902.isj20205666