Monday, December 4, 2017

Malunion # Metacarpal ORIF

Malunion # Metacarpal Fixation


There are two variety of healing u will en contour after improper fixation.Either Non union or Malunion.Both of them will result in restricted range of movements. 
Dorsal hump here shows the angulation of distal segment dorsally.
There is restriction of movements of the  Mcpjts.


Always a antero-posterior view and oblique views are required to identify a fracture union.This x-ray shows fracture mal union meaning it has united but not in anatomical position,this results in restricted active range of movements


Incision is made at the summit of the swelling.Exposed tendon are separated from bony swelling.Soft callus formed all round the mal union is chiseled out and raw area is created exposing fresh bone with medullary cavity. 


Saline wash given.K wire inserted proximodistally.Good reduction achieved .
Volar slab given with hand elevation.


Final hemostasis is done and a volar slab is applied for 21 days.10th day suture removal.2 weeks post 21 days active mobilisation and followed by active and passive mobilisation  until full range of movements.

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