[Mini-invasive osteosynthesis in injuries of the metacarpal bones in children]

Injuries of the metacarpal bones in child and adolescent age are much less frequent than in adult age. Most frequently the IVth and Vth metacarpal bone are affected where paradoxically in the distal area metaphyseal fractures predominate over injuries of the physes. During the period between 1994-1998 on account of this injury in our department a total of 11 patients were treated by the method of miniinvasive osteosynthesis. In 7 instances treatment by means of a Kirschner wire was used in injuries of the base of the 1st metacarpal bone, incl. four cases where a physeal separation of the Salter-Harris II type was involved, once a physeal fracture of the Salter-Harris III type and twice a metaphyseal injury. In four patients the subcapital fracture of the metacarpal bone was transfixed. In all instances one implant was used. A total of 11 excellent results were recorded. In one injury of the 1st metacarpal bone slight restriction of movements in the metacarpophalangeal joint occurred. Miniinvasive osteosynthesis, if indicated, is a reliable and simple method with excellent results. A thin Kirschner wire which should be always inserted, avoiding adjacent joints, is a satisfactory implant.