Surgical outcome of collateral ligament injury with metacarpal head fracture in a near amputation after power saw injury: Case report

INTRODUCTION: The incidence of thumb amputation is high in developing and industrialized countries. A power saw injury is very traumatic to the soft tissue and neurovascular system, and thus difficult for orthopedic and plastic surgeons to treat. PRESENTATION OF CASE: A 41 year old male injured his right hand with a power saw. The poor condition of the soft tissue and collateral ligament damage to the head of the metacarpal fracture meant that near amputation was a possibility. The patient received adequate antibiotic and was taken to the operating room for fixation with convergent screws system, repaired and reconstructed collateral ligament complex. At 3 month follow up, author saw the union of the intraarticular fracture and the metacarpophalangeal joint (MCP). The patient was followed up at 1 year, the sensory and function was full recovered. The patient was extremely satisfied with this treatment and can now work normally again. DISCUSSION: The collateral ligament complex injury with metacarpal head fracture in a near amputation after power saw injury; it is a very unstable injury. In this case, author performed an early adequate intravenous antibiotics in the emergency room and was taken to the operating room for repair and reconstruction. Neurological status and hand function were recovered that patient was extremely satisfied in this surgical planning. CONCLUSION: The power saw injury is a severe injury which requires special attention for treatment. Furthermore, the early reparation, reconstruction and fixation with screws in a convergent system is the treatment of choice in this condition.