Beşinci Metakarp Boyun Kırıklarında Yüksek Volar Açılanma Fonksiyonel Olarak Tolere Edilebilir mi? Konservatif Tedavi Sonuçlarının Retrospektif Serisi

Abstract

Giriş: Bu çalışmanın amacı, beşinci metakarp boyun kırığı tanısı almış ve 45° veya daha fazla volar açılanması olup konservatif yöntemle tedavi edilen olgularda klinik ve fonksiyonel sonuçları değerlendirmektir. Yöntemler: Çalışmaya, Eylül 2021 ile Eylül 2024 tarihleri arasında 45°’ten fazla volar açılanması bulunan beşinci metakarp boyun kırığı tanısı almış ve konservatif olarak tedavi edilmiş 49 erkek hasta dahil edildi. Tüm hastalar ulnar gutter splint ile tedavi edildi. Son takipte hastaların klinik değerlendirmelerinde Görsel Ağrı Skalası (VAS), Quick-Disabilities of the Arm, Shoulder and Hand (Q-DASH), Fonksiyonel Skorlama Sistemi (FSS), metakarpofalangeal (MP), proksimal interfalangeal (PIP) ve distal interfalangeal (DIP) eklemlerinin hareket açıklığı (ROM) ile kavrama gücü değerlendirildi. Bulgular: Hastaların ortalama yaşı 33,75 ± 9,50 yıl, ortalama takip süresi ise 19,93 ± 4,31 aydı. En sık yaralanma mekanizması yumruk atma (%69,4) olarak belirlendi ve vakaların %85,7’sinde sağ el etkilenmişti. Ortalama VAS skoru 0,12 ± 0,48, Q-DASH skoru 1,48 ± 2,52 ve FSS skoru 29,53 ± 0,98 olarak ölçüldü. Ortalama eklem hareket açıklıkları MP: 91,3 ± 3,8°, PIP: 107,6 ± 5,9° ve DIP: 84,6 ± 5,6° idi. Ortalama kavrama gücü ise 44,18 ± 7,64 kg olarak saptandı. Sonuç: Bu çalışma, 45° ve üzeri açılanmaya sahip beşinci metakarp boyun kırıklarında konservatif tedavi ile iyi fonksiyonel sonuçlar elde edilebileceğini ve hareket açıklığının korunabildiğini göstermektedir.

Keywords

• Beşinci metakarp boyun kırığı
• Konservatif tedavi
• Açılanma
• El cerrahisi

Is High Volar Angulation in Fifth Metacarpal Neck Fractures Functionally Tolerable? A Retrospective Series of Conservative Treatment Outcomes

Abstract

Aim: This study aimed to evaluate the clinical and functional outcomes in cases with a volar angulation of 45° or more who were treated conservatively for fifth metacarpal neck fractures. Material and Methods: The study included 49 male patients diagnosed with a fifth metacarpal neck fracture and treated conservatively with a volar angulation greater than 45° between September 2021 and September 2024. All patients were treated with an ulnar gutter splint. At the final follow-up, assessments included the Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH), Functional Scoring System (FSS), range of motion (ROM) of the metacarpophalangeal (MP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints, and grip strength. Results: The average age of the patients was 33.75 ± 9.50 years, with a mean follow-up duration of 19.93 ± 4.31 months. The most common injury mechanism was punching (69.4%), and the right hand was affected in 85.7% of cases. The mean VAS score was 0.12 ± 0.48, the mean Q-DASH score was 1.48 ± 2.52, and the mean FSS score was 29.53 ± 0.98. The average ROM measured was MP: 91.3 ± 3.8°, PIP: 107.6 ± 5.9°, and DIP: 84.6 ± 5.6°. The mean grip strength was 44.18 ± 7.64 kg. Conclusion: This study demonstrates that for fifth metacarpal neck fractures with an angulation of 45° or more, conservative treatment can achieve good functional outcomes and maintain ROM.

Keywords

• Fifth metacarpal neck fracture
• conservative treatment
• angulation
• hand surgery

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