Closed Free Hand Proximal-Distal Imn of Metacarpal Fractures by 1-2 Kirchner Wires a Retrospective Case Series

Avshalom Carmel
Orthopaedics, Laniado Hospital, Israel

Objective: To show that closed proximal-distal "free hand" imn of border MC shaft and neck metacarpal fractures by a single or double k wires (" Fouche technique") is a safe and reliable technique Method: I used a 1.6-1.8 m "m k- wire that was pre bent by a pliers to a slightly curved bow and inserted freehand with a T handle from the MC base. 1-2 k wires are used. Reported are clinical and radiological results and complications in 15 cases. Results: operation time was around 20-30 minutes. All fractures united within 2-3 months, there were no rotational deformities or significant residual angulation or shortening. There were few minor complications: 2 pin tract infections, 2 patients required intraoperative procedure modification to an open reduction, I pt. had partial loss of PIPJ extension 1 had re-fracture over a retained k wire). Conclusion: the method is reliable, low- cost, readily available and relatively safe with 100% union. 1 k wire usually suffices. It is easier to perform in border metacarpals.