Minimally Invasive Technique for Metacarpal Fracture Fixation

September 7th, 2008

Although a nondisplaced, or minimally displaced metacarpal fracture may often be amenable to nonoperative treatment in a cast or splint, the classic indications for operative treatment remain unacceptable displacement and/or angulation.

In such cases, the goals of reduction, stability, and early finger motion have been achieved via a lengthy incision on the the top of the hand in conjuction with a plate and screws. This technique continues to be popular--and advances in the devices: low profile (thinner) plates, better materials, more shapes and versatility, continue to improve this option.

However, a fairly new and novel fixation system exists which allows minimally invasive fracture fixation.The SBFS (small bone fixation system) includes small rods/pins that can be placed through a 5 mm incision at the base of the metacarpal. It runs within the bone, beyond the fracture, to engage the cortex distally. It obviates the use of large incisions and excessive dissection. This allows quicker soft tissue recovery, smaller scars, and less pain.

Related Photos:

1. Preop AP hand xray shows 4th and 5th metacarpal fractures

2. Preop Lat xray shows angulation of the fractures

3. Postop AP xray after stabilization with the Small Bone Fixation System (SBFS)

4. Postop Lat xray. These pins will be removed 6-8 weeks after the index operation