Irreducible metacarpal neck fracture caused by interposition of junctura tendinum

Abstract

Most metacarpal neck fractures can be reduced using the close reduction technique. However, if acceptable reduction cannot be achieved by closed reduction, open reduction is indicated. A 37-year-old patient had a third metacarpal neck fracture. We tried to reduce the metacarpal neck fracture by using closed reduction methods, but failed to do so. We performed open exploration and observed that the cause of failure was interposition of the junctura tendinum (JT) connecting the third and fourth extensor digitorum tendons. The JT in the third or fourth intermetacarpal space can interpose between the fragments in cases of third, fourth, or fifth metacarpal neck fractures, because the JT in the third or fourth intermetacarpal space is thick and wide (type 2 or 3). The JT in the third or fourth intermetacarpal space should be considered as a potential obstacle to the reduction in cases of irreducible metacarpal neck fractures. [ABSTRACT FROM AUTHOR]Copyright of Hand Surgery is the property of World Scientific Publishing Company and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)