Fifth metacarpal neck fracture fixation: antegrade intramedullary pinning with two K-wires or percutaneous retrograde crossed pinning

Year 2022, Volume: 5 Issue: 4, 1190 - 1194, 20.07.2022

Fırat Fidan Mehmet Ümit Çetin

https://doi.org/10.32322/jhsm.1116129

Cited By: 1

Abstract

Objective: The present study aimed to compare clinical and radiological outcomes in patients with displaced fifth metacarpal neck fractures after treatment with antegrade intramedullary pinning with two K-wires or percutaneous retrograde crossed pinning.
Material Method: While seventeen patients were treated with antegrade intramedullary pinning (Group ), 14 were treated with percutaneous retrograde crossed pinning (Group 2). Clinical and radiological outcomes included Quick Dash, active range of motion (ROM), VAS, and dorsal angulation loss at weeks four and twelve and in the final follow-up.
Results: The findings revealed that the groups had mean ages of 29.41±8.15 years and 27.78±7.42 years, res-pectively. While ROM was better in Group 2 at weeks four and twelve, we could not find a significant difference between the groups by active ROM in the final follow-up. Moreover, Group 1 had a better Dash score in the fourth week and twelth week , but both groups had similar Dash scores in the final follow-up. Finally, the groups had no preoperative and postoperative differences radiologically.
Conclusion: The present findings uncovered that treatment of a displaced fifth metacarpal neck fracture by anteg-rade intramedullary pinning yielded a better in the first three months improvement in active ROM and Quick Dash than percutaneous retrograde crossed pinning.

Keywords

Fifth metacarpal fracture, percutaneous retrograde crossed pinning, intramedullary anteg-rade pinning

References

• Ali A, Hamman J, Mass DP. The biomechanical effects of angulated boxer’s fractures. J Hand Surg 2006; 24: 835- 44.
• Başar B, Polat A. Safety Evaluation of Early Active and Passive Motion Without Immobilization in Metacarpal Fractures. J Acad Res Med 2021;11: 283-7.
• Kim, Jae Kwang, and Dong Jin Kim. Antegrade intramedullary pinning versus retrograde intramedullary pinning for displaced fifth metacarpal neck fractures. Clinical Orthopaedics and Related Research 2015; 473: 1747-54.
• Nakashian MN, Pointer L, Owens BD, Wolf JM.Incidence of metacarpal fractures in the US population. Hand 2012; 7: 426-30.
• Hussain MH, Ghaffar A, Choudry Q, Iqbal Z, Khan MN. Management of fifth metacarpal neck fracture (boxer's fracture): a literature review. Cureus 2020; 12: 7-10
• Schadel-Hopfner M, Wild M, Windolf J, Linhart W. Antegrade intramedullary splinting or percutaneous retrograde crossed pinning for displaced neck fractures of the fifth metacarpal? Arch Orthop Trauma Surg 2007; 127: 435–40
• Wong TC, Ip FK, Yeung SH. Comparison between percutaneous transverse fixation and intramedullary K-wires in treating closed fractures of the metacarpal neck of the little finger. J Hand Surg Br 2006; 31: 61–5
• Zeng L, Zeng L, Miao X, Chen Y, Liang W,Jiang Y. Single versus dual elastic nails for closed reduction and antegrade intramedullary nailing of displaced fifth metacarpal neck fractures. Scientific Reports 2021; 11: 1-9.
• Muller MG, Poolman RW, van Hoogstraten MJ ,Steller E P. Immediate mobilization gives good results in boxer’s fractures with volar angulation up to 70 degrees: a prospective randomized trial comparing immediate mobilization with cast immobilization. Archives of orthopaedic and trauma surgery 2003; 123: 534-7.
• Padegimas EM, Warrender WJ, Jones CM, Ilyas, AM. Metacarpal neck fractures: a review of surgical indications and techniques. Archives of trauma research 2016; 5: 3-6.
• Baydar M, Aydın A, Şencan A, Orman O, Aykut S. Comparison of clinical and radiological results of fixation methods with retrograde intramedullary Kirschner wire and plate-screw in extra-articular metacarpal fractures. Joint diseases and related surgery 2021; 32: 397-1.
• Southam M, Driessens S, Burton C, Pope R, Thurnwald P. A retrospective cohort study of QuickDASH scores for common acute trauma conditions presenting for hand therapy. Journal of Hand 2017; 30: 41-8.
• Facca S, Ramdhian R, Pelissier A, Diaconu M, Liverneaux D. Fifth metacarpal neck fracture fixation: locking plate versus K-wire?.” Orthopaedics & Traumatology: Surgery & Research 2010 ; 96: 506-12.
• Calder JDF, S. O’Leary, and SC Evans. Antegrade intramedullary fixation of displaced fifth metacarpal fractures. Injury 2000; 311: 47-0.
• She Yuanshi and Youjia Xu. Treatment of fifth metacarpal neck fractures with antegrade single elastic intramedullary nailing. BMC Musculoskeletal Disorders 2017; 18: 1-5.