J Korean Orthop Assoc.  2013 Aug;48(4):314-318.

Correction of Congenital Metacarpal Synostosis with Polypropylene Mesh as an Interpositional Material

• Kang HJ
• Kwak YH

Abstract

Metacarpal synostosis is an uncommon congenital hand malformation characterized by the coalescence of two or more adjacent metacarpals. Patients visit the hospital due to abduction deformity, which is usually a mild deformity or a minor functional deficit. This is one of the reasons why the patient goes to the hospital late and foregoes proper management with early detection and treatment. A number of surgical procedures ranging from simple to complex have been employed for treatment of this deformity. We describe our experience with a longitudinal osteotomy, realignment of component metacarpals with the metacarpophalangeal joint, and interposition of a non-absorbable polypropylene mesh used for inguinal hernia for correction of the abducted deformity and prevention of recurrence of synostosis while minimizing morbidity.

Keyword

metacarpal bones; synostosis; polypropylenes; surgical mesh

MeSH Terms

Congenital Abnormalities
Hand
Hernia, Inguinal
Humans
Metacarpal Bones
Metacarpophalangeal Joint
Osteotomy
Polypropylenes
Recurrence
Surgical Mesh
Synostosis
Polypropylenes

Figure

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  Figure 1 Preoperative evaluation. (A) Clinical photo of the hand shows marked abduction of the fifth finger. (B) Preoperative radiographs show bilateral metacarpal synostosis of the fourth and fifth fingers. (C) Preoperative magnetic resonance image shows a hypoplastic metacarphop haryngeal joint.

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  Figure 2 Surgical procedure. (A) Polypropylene mesh is crumpled into a roll. (B) Obvolutive mesh is inserted into the osteotomy site. (C) The mesh is held in place and a Kirschner's wire is fixed for stability of the joint.

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  Figure 3 Postoperative evaluation. (A) Clinical photo of the patient at final follow-up shows functional improvement with corrected deformity. (B) Final radiographs show no recurrence.

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