# Tension Band Wiring in the Treatment of Extensor Carpi Radialis Longus Avulsion Fractures at the Base of the Second Metacarpal: A Case Report and Literature Review

## TL;DR

This paper reports a successful surgical treatment using tension band wiring for a rare hand fracture, which has not been previously documented.

## Contribution

The first reported use of tension band wiring for extensor carpi radialis longus avulsion fractures at the second metacarpal base.

## Key findings

- Surgical treatment of similar injuries had better outcomes than conservative management.
- Tension band wiring provided favorable results in this case.
- Previously reported fixation methods included Kirschner wires, screws, or miniplates.

## Abstract

An avulsion fracture of the second metacarpal is a rare injury often resulting from resisted wrist hyperflexion, and there is no consensus on the optimal treatment. A review of the literature reveals 20 articles documenting 25 cases of similar injuries. Of these, nine cases were initially managed conservatively, while 16 were treated surgically. Among the nine conservative cases, five (55.6%) required late surgical intervention due to unsuccessful initial treatment. In contrast, none of the 16 surgically treated cases reported poor clinical outcomes. This case involves a 23-year-old male with an extensor carpi radialis longus avulsion fracture at the base of the second metacarpal, treated with open reduction and tension band wiring. The patient achieved favorable postoperative results. In other reported cases, fixation methods included Kirschner wires, screws, or miniplates. To our knowledge, this is the first case using tension band wiring for this type of injury.