Metacarpal fracture surgery with screws2/29/2024 8įoucher 5 first introduced CRIF using flexible IM Nails in 1976 9 before introducing the bouquet technique in 1995. 5, 6, 7, 8 However, intramedullary fixation provides the advantages of a simplified technique, minimal soft tissue dissection, a smaller incision, reduced tendon irritation, and decreased scar formation. 2, 3 Open reduction with plate fixation and closed reduction with intramedullary fixation (CRIF) have been reported to have comparable functional outcomes for extra-articular metacarpal fractures. 4 Current concepts have been described for the surgical fixation of unstable, displaced, and multiple metacarpal fractures including intramedullary nail (IM Nail) fixation, open reduction internal fixation (ORIF), and a variety of plate and screw fixation techniques. 2, 3 Although many nondisplaced metacarpal fractures can be treated with conservative management, displaced, unstable, open, and extra-articular fractures require surgical attention. 1 With nearly 36% of hand fractures occurring at the metacarpal, a variety of interventions have been developed to treat these injuries. Hand fractures are the second most common fracture of the upper extremity. Our reported case series suggests procedural efficiency, a low complication rate, and fast recovery for those with indicated extra-articular fractures. The design and surgical technique of the premeasured Secure Intramedullary Nail improves fracture fixation, minimizing rotation and backing out, while reducing concerns for soft tissue irritation complications at the base of the metacarpal. The current study reports on the improved surgical technique associated with the use of novel instrumentation for the closed reduction and intramedullary fixation of extra-articular metacarpal fractures. Compared with open reduction with plate fixation, closed reduction with intramedullary fixation has shown advantages of a simplified technique, minimal soft tissue dissection, and reduced tendon irritation and scar formation. Although many nondisplaced metacarpal fractures can be treated with conservative management, displaced, unstable, open, and extra-articular fractures require surgical attention. With nearly 36% of hand fractures occurring at the metacarpal, a variety of treatment interventions have been developed.
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