Perioperative management - Intramedullary K-wire osteosynthesis of a subcapital fracture of the fifth metacarpal

• Palmar tilt of more than 45°
• Rotational error

• Local or general diseases that contraindicate elective surgery surgically or anesthesiologically, or are improvable preoperatively

• Clinical examination (rotation error!)
• X-ray examination of the hand, anteroposterior and strictly lateral, to determine the extent of angulation

• no special preparation of the patient necessary
• generally an outpatient procedure
• clarification of contraindication for bloodlessness (e.g., existing shunt in dialysis)

Information about:

• surgical method
• metal allergy (nickel)
• general surgical risks (wound healing disorder, functional deficit wrist/hand, CRPS)
• specific surgical risks:

1. Injury to R. dorsalis N. ulnaris with neuropathic pain - prolonged scar pain (usually subsides after 6 months)
2. insufficient correction
3. injury to the bone/joint by perforating wire, tendon injury
4. pseudoarthrosis