title: [Elastic titanium nails for minimally invasive intramedullary splinting of metacarpal fractures].
abstract: OBJECTIVE
  The goal in treatment of metacarpal fractures is to restore the normal function of the hand. Although a majority of these fractures can be treated non-operatively, surgery is recommended for displaced fractures and in case of a patient wish for primary stability for practise. A poor clinical outcome is described for metacarpal shortening of more than 5 millimeters and for rotational deformity. Whereas plate osteosynthesis may lead to soft tissue irritation involving tendon adhesions and scar formation, we have used the elastic stable intramedullary nailing [ESIN] technique using titanium elastic nails (TEN) for intramedullary splinting of short metacarpal shaft and neck fractures.
  
  
  METHODS
  Within 5 years, ESIN was performed in 95 patients. The operative technique was evaluated retrospectively concerning its functional results and complications.
  
  
  RESULTS
  Sixty-three patients were analysed after an average follow-up of 14.0 ± 5.2 weeks. The mean DASH-Score was 2.3 ± 3.9 points. We saw one implant out-of-position and three cases of skin irritation affording TEN shortening. Two superficial wound infections were treated conservatively. Pseudarthrosis and nail breakage were not observed. After TEN removal 9 ± 2.4 weeks post implantationem no refracture occurred.
  
  
  CONCLUSIONS
  Minimally invasive intramedullary stabilisation of short metacarpal shaft and neck fractures with a TEN is a safe surgical technique and achieves primary stability for practise. It reliably leads to fracture healing and produces excellent functional results.
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: M C
authors.initials: MC
authors.lastname: Müller
authors.forename: K
authors.initials: K
authors.lastname: Welle
authors.forename: M
authors.initials: M
authors.lastname: Windemuth
authors.forename: C
authors.initials: C
authors.lastname: Burger
authors.forename: P H
authors.initials: PH
authors.lastname: Pennekamp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D055119:Elastic Modulus; D019544:Equipment Failure Analysis; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D011474:Prosthesis Design; D011859:Radiography; D012189:Retrospective Studies; D013165:Splints; D014025:Titanium; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014025:Titanium