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The Use of External Fixator and Iliac Crest Bone Graft in Traumatic Metacarpal Bone Defect

INTRODUCTION: Metacarpal bone fractures often lead to significant shortening in the phalanges; it can be caused by variable conditions, ranging from idiopathic, and infective to traumatic causes. There are very rare reports of metacarpals shortening in idiopathic primary hypoparathyroidism cases in...

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Autores principales: Korkmaz, Oguzhan, Abourdan, Joud, Birinci, Murat, Bostanci, Bilal, Kara, Adnan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088377/
https://www.ncbi.nlm.nih.gov/pubmed/37056598
http://dx.doi.org/10.13107/jocr.2022.v12.i12.3458
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author Korkmaz, Oguzhan
Abourdan, Joud
Birinci, Murat
Bostanci, Bilal
Kara, Adnan
author_facet Korkmaz, Oguzhan
Abourdan, Joud
Birinci, Murat
Bostanci, Bilal
Kara, Adnan
author_sort Korkmaz, Oguzhan
collection PubMed
description INTRODUCTION: Metacarpal bone fractures often lead to significant shortening in the phalanges; it can be caused by variable conditions, ranging from idiopathic, and infective to traumatic causes. There are very rare reports of metacarpals shortening in idiopathic primary hypoparathyroidism cases in the literature. Traumatic metacarpal shortening differs from congenital agenesis [2]. This condition leads to both functional and cosmetic limitations which affect the patient’s quality of life. CASE REPORT: A 22-year-old male patient was admitted to our outpatient clinic with a traumatic left-hand fracture that caused a bone defect in the second metacarpal shaft leading to bone loss, shortening and flexion limitation in the second finger of the left hand, and a flexion contracture in the first metacarpophalangeal joint. For the treatment plan, an external fixator was set on the second metacarpal of the left hand for a 23 mm elongation over a period of 58 days, elongation rate was organized as 1 mm/day. After achieving the planned elongation, another operation was planned for the reconstruction of the bone defect that has occurred due to trauma in the second metacarpal bone. An osteotomy was performed for extracting an iliac crest graft and inserting it into the bone defect after debridement of scar tissue. For the first metacarpophalangeal joint, an arthrodesis was performed through the use of plate and screws. Multiple studies have showed a common complication of pin tract infections, which were controlled with oral antibiotics and local wound care [10, 11]. Proper alignment and union were achieved with early, stable fracture fixation of low-velocity gunshot wounds of the metacarpal. With early rehabilitation, treatment was provided without an increase in morbidity. [11]. CONCLUSION: It is possible to obtain acceptable surgical results when the method of fixation of the defect with autograft is used after lengthening with external fixator in pseudoarthrosis with metacarpal defect.
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spelling pubmed-100883772023-04-12 The Use of External Fixator and Iliac Crest Bone Graft in Traumatic Metacarpal Bone Defect Korkmaz, Oguzhan Abourdan, Joud Birinci, Murat Bostanci, Bilal Kara, Adnan J Orthop Case Rep Case Report INTRODUCTION: Metacarpal bone fractures often lead to significant shortening in the phalanges; it can be caused by variable conditions, ranging from idiopathic, and infective to traumatic causes. There are very rare reports of metacarpals shortening in idiopathic primary hypoparathyroidism cases in the literature. Traumatic metacarpal shortening differs from congenital agenesis [2]. This condition leads to both functional and cosmetic limitations which affect the patient’s quality of life. CASE REPORT: A 22-year-old male patient was admitted to our outpatient clinic with a traumatic left-hand fracture that caused a bone defect in the second metacarpal shaft leading to bone loss, shortening and flexion limitation in the second finger of the left hand, and a flexion contracture in the first metacarpophalangeal joint. For the treatment plan, an external fixator was set on the second metacarpal of the left hand for a 23 mm elongation over a period of 58 days, elongation rate was organized as 1 mm/day. After achieving the planned elongation, another operation was planned for the reconstruction of the bone defect that has occurred due to trauma in the second metacarpal bone. An osteotomy was performed for extracting an iliac crest graft and inserting it into the bone defect after debridement of scar tissue. For the first metacarpophalangeal joint, an arthrodesis was performed through the use of plate and screws. Multiple studies have showed a common complication of pin tract infections, which were controlled with oral antibiotics and local wound care [10, 11]. Proper alignment and union were achieved with early, stable fracture fixation of low-velocity gunshot wounds of the metacarpal. With early rehabilitation, treatment was provided without an increase in morbidity. [11]. CONCLUSION: It is possible to obtain acceptable surgical results when the method of fixation of the defect with autograft is used after lengthening with external fixator in pseudoarthrosis with metacarpal defect. Indian Orthopaedic Research Group 2022-12 2022-12 /pmc/articles/PMC10088377/ /pubmed/37056598 http://dx.doi.org/10.13107/jocr.2022.v12.i12.3458 Text en Copyright: © Indian Orthopaedic Research Group https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Unported, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms
spellingShingle Case Report
Korkmaz, Oguzhan
Abourdan, Joud
Birinci, Murat
Bostanci, Bilal
Kara, Adnan
The Use of External Fixator and Iliac Crest Bone Graft in Traumatic Metacarpal Bone Defect
title The Use of External Fixator and Iliac Crest Bone Graft in Traumatic Metacarpal Bone Defect
title_full The Use of External Fixator and Iliac Crest Bone Graft in Traumatic Metacarpal Bone Defect
title_fullStr The Use of External Fixator and Iliac Crest Bone Graft in Traumatic Metacarpal Bone Defect
title_full_unstemmed The Use of External Fixator and Iliac Crest Bone Graft in Traumatic Metacarpal Bone Defect
title_short The Use of External Fixator and Iliac Crest Bone Graft in Traumatic Metacarpal Bone Defect
title_sort use of external fixator and iliac crest bone graft in traumatic metacarpal bone defect
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088377/
https://www.ncbi.nlm.nih.gov/pubmed/37056598
http://dx.doi.org/10.13107/jocr.2022.v12.i12.3458
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