Transverse K wiring for metacarpal fractures

Swollen hand following a punch injury causing fractures (breaks) of the ring finger (RF) and little finger (LF) metacarpal bones

X-rays showing the RF and LF metacarpal (breaks) fractures. These were unstable injuries and could not be held in plaster

X-ray during the operation showing the first wire going into the LF metacarpal bone distal to (beyond) the fracture

First wire drilled across the LF and Rf metacarpals and up to the middle finger (MF) metacarpal. This was done under local anaesthetic

First wire has been passed across the LF and RF and into but not through the MF metacarpal. Note the fractures have been reduced

Side view confirms the wire is in all the three metacarpal bones

Second wire paseed across the LF and Rf metacarpal bones and into but not beyond the MF metacarpal

Repeat side view again confirms the wire is in all 3 bones. The MF is the stable strutt that holds the fractures aligned

A third wire is placed proximally for extra stability

A further side view confirms the wires are al in 3 bones each