[Intramedullary fixation within bones of the hand: 20 years of experience]

Intramedullary fixation within bones of the hand has been used for treatment of 313 fractures in 169 patients after serious trauma or replantation between 1978 and 1998. Kirschner wires or Steinmann pins were introduced at the fracture site and anchored within both metaphyses. The method was used in various types of fractures, comminuted ones and bone defects included. In all cases fracture healed between 4 and 8 weeks. No deep infection occurred, in 2 patients the implants had to be removed because of their migration. The method is technically undemanding and allows for immediate postoperative rehabilitation. Total range of motion exceeded by 15% results achieved in patients treated with temporary immobilization of the hand.