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Journal of Hand Surgery (British and European Volume)
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Articles

Late Reconstruction of Neglected Metacarpal Shaft Defects Due to Gunshot Wound

IBRAHIM AKMAZ
AHMET KIRAL
OZCAN PEHLIVAN
MAHIR MAHIROGULLARI
CAN SOLAKOGLU
OSMAN RODOP
MESIH KUSKUCU

From the Department of Orthopedics and Traumatology, Gulhane Military Medical Academy and Medical Faculty Hospital, Istanbul, Turkey

Correspondence: Prof Dr Ahmet KIRAL, GATA Haydarpasa Egitim Hastanesi Ortopedi ve Travmatoloji Servisi, Üsküdar 34668, ISTANBUL, Turkey. Tel:+90-0-(216)-345-02-95/2693; fax:+90-0- (216)-348-78-80. E-mail: iakmaz1{at}superonline.com (A. Kiral).

We evaluated eight patients after delayed treatment of nine metacarpal bone defects due to gunshot injuries. The mean length of the metacarpal defects was 3 cm and the average time between the gunshot injury and the reconstruction surgery was 10 months. Although all of the patients had been treated with wound irrigation and debridement immediately following injury, no attempt had been made to repair the metacarpal defect or to maintain metacarpal length. As a result, serious shortening had occurred. After the original length of the metacarpal had been restored by distraction of the soft tissues (1 mm/day), a tri-cortical iliac bone graft was inserted into the bone defect. The average follow-up time was 15 months. Clinical and radiological union was established in all cases after an average of 12 weeks. The mean grip strength of the hand and the mean range of motion of the metacarpophalangeal joint increased by 24% and 60%, respectively.

Key Words: fracture • metacarpal defect • neglected

Journal of Hand Surgery (British and European Volume), Vol. 29, No. 6, 585-589 (2004)
DOI: 10.1016/J.JHSB.2004.05.009
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