Modified Bouquet Technique for Treatment of Metacarpal Neck Fractures

Sung,  Yong Gyu; Song,  Seok Whan; Lee,  Yoon Min

doi:2016.21.3.137

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Original Article

Journal of the Korean Society for Surgery of the Hand 2016;21(3):137-143.
Published online September 30, 2016.
DOI: https://doi.org/10.12790/jkssh.2016.21.3.137

Modified Bouquet Technique for Treatment of Metacarpal Neck Fractures

Yong Gyu Sung, Seok Whan Song, Yoon Min Lee

Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. simba0415@catholic.ac.kr

Received: 14 June 2016 • Revised: 30 August 2016 • Accepted: 7 September 2016

Abstract

Purpose
The purpose of this study was to report the clinical outcome of "modified Bouquet technique", as a simple and effective internal fixation with Kirschner-wire for the metacarpal neck fractures.

Methods
Sixty-seven patients with metacarpal neck fracture treated by modified Bouquet technique were retrospectively reviewed. The operation time and removal time were evaluated. For radiologic evaluation, posterior angulation of fracture and metacarpal shortening were measured pre and postoperatively. For clinical evaluation, range of motion of metacarpophalangeal joint, Green and O'Brien score were evaluated.

Results
Preoperative neck shaft angle of metacarpal bone was 46.0° and length of metacarpal bone was 51.2 mm, and postoperative neck shaft angle was 24.4° (p=0.003) and length of metacarpal length was 52.8 mm (p=0.031) in average. The mean range of motion was 86.6° and Green and O'Brien score was 96.1 points at last visit. We had one complicated case with type II complex regional pain syndrome of affected hand with hypertrophic scar formation.

Conclusion
Modified Bouquet technique for metacarpal neck fracture is a good method using just two K-wires, plier and mallet without electric devices in short operation time. The technique can correct angulation of fracture site, rotation of finger and metacarpal shortening by controlling inserted K-wires with high bone union rate with less joint stiffness.

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