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Customized staple fixation in hand and wrist surgery
1Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore.
Journal of Hand Surgery (Edinburgh, Scotland)
|February 11, 1998
Summary
This study introduces a new technique for fixing small hand bones using custom K-wire staples. This safe and cost-effective method provides stable fixation for carpal bones and phalangeal epiphysiodesis in both children and adults.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Pediatric orthopedics
Background:
- Fixing small bones in pediatric and adult hands presents significant surgical challenges.
- Current methods may lack precision for optimal axial alignment and rotational stability.
Purpose of the Study:
- To present an innovative technique for small bone fixation in the hand using intraoperatively customized staples.
- To evaluate the efficacy and safety of this technique for carpal bone fixation and phalangeal epiphysiodesis.
Main Methods:
- Custom staples were fashioned intraoperatively from K-wires (0.9-1.6 mm diameter).
- The technique was applied to 14 patients (11 adults, 3 children) for carpal bone fixation and phalangeal epiphysiodesis.
- The malleable nature of K-wires allowed for contour-following staple customization.
Main Results:
- All 14 cases achieved satisfactory bony fixation, meeting preoperative goals.
- No instances of bone shattering, implant breakage, loosening, or infection were reported.
- The custom staples provided precise axial alignment and rotational stability.
Conclusions:
- Intraoperatively customized K-wire staples offer a safe, precise, and technically straightforward method for small bone fixation in hand surgery.
- This technique is cost-effective, requires only standard instruments, and yields excellent clinical outcomes.
- It is a viable option for both adult and pediatric hand reconstructions, including carpal bone fixation and epiphysiodesis.