This anatomical study defines a safe zone for percutaneous or minimally invasive fixation of first metacarpal fractures in order to avoid injury of the superficial branch of the radial nerve and the dorsal branch of the radial artery. The courses of the nerve and artery branches were marked in 20 embalmed cadaver specimens. With computer-assisted surgical anatomy mapping, a large diversity in the anatomical patterns for the nerve and a consistent pattern for the artery were found. Based on these findings, we conclude that transfixation of the first and the second metacarpals with K-wires placed in the distal 75% of both the first and second metacarpals is the safest way to avoid damages to the nerve and artery branches during fracture fixation.

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Keywords Anatomical study, computer-assisted surgical anatomy, first metacarpal fracture, minimal invasive surgery, safe zone
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Series VSNU Open Access deal
Journal Journal of Hand Surgery (European Volume)
Note corresponding author at , Haga Teaching Hospital & Juliana Children’s Hospital Den Haag
Greeven, A.P.A, Van Groningen, J. (Jorg), Poublon, A.R, van Lieshout, E.M.M, Kleinrensink, G.J, & Verhofstad, M.H.J. (2019). Safe approach for fixation of first metacarpal fractures: an anatomical study. Journal of Hand Surgery (European Volume). doi:10.1177/1753193419859364