A single antegrade intramedullary k-wire for fifth metacarpal neck fractures

Assi, Chahine; Mansour, Jad; Samaha, Camille; Ajjoub, Sleiman; Yammine, Kaissar

doi:10.1007/s00068-018-01073-2

Cited by 14 publications

(9 citation statements)

References 32 publications

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“…Though we are unable to measure an exact malrotation of the metacarpal in our population, finger scissoring had never been noticed. Early postoperative mobilization, from our experience and many reported literature studies, does not produce rotational deformity [ 14 , 15 , 19 , 21 – 26 , 31 ].…”

Section: Discussionmentioning

confidence: 78%

“…No malrotation was seen in the metacarpal fracture with no initial rotatory displacement even after early mobilization of the DTML was intact [ 31 ]. Rotatory displacement after the flexible fixation of metacarpal fracture is rare [ 7 , 18 , 19 , 21 , 23 , 24 , 26 , 40 , 44 , 45 ]. Though we are unable to measure an exact malrotation of the metacarpal in our population, finger scissoring had never been noticed.…”

Section: Discussionmentioning

confidence: 99%

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Single Buried Intramedullary K-Wire Fixation in Nonthumb Metacarpal Shaft Fractures with Immediate Postoperative Mobilization without Any Immobilization

Siriwittayakorn,

Adulkasem,

Sangthongsil

et al. 2023

Advances in Orthopedics

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Objective. This study aims to evaluate the outcomes of single intramedullary K-wire fixation in nonthumb, metacarpal shaft fractures with immediate postoperative hand mobilization without any immobilization. Method. This is a retrospective case series conducted from January 2019 to December 2022. We included patients with closed, simple transverse, or short oblique metacarpal shaft fracture treated with single, 1.4 mm, intramedullary K-wire fixation. Gentle postoperative range of motion exercise was encouraged in every patient without any hand, finger, or wrist motion restriction material. Clinical outcomes were evaluated with total active flexion; grip strength; disability of arm, shoulder, and hand (DASH) score; and the American Society for Surgery of the Hand Total Active Flexion (ASSH TAF) score. Results. This study included 34 patients, 25 males and 9 females with a mean age of 33.14 years (ranging 18–59). A total of 43 metacarpal shafts were treated. The mean DASH score at two and 6 weeks postoperative was 41.5 (ranging 19.16–60.34) and 9.58 (ranging 0.83–23.27). The mean final DASH score at last follow-up was 3.48 (ranging 0–8.33). Mean TAF at 2 weeks postoperative, 6 weeks postoperative, and at final follow-up was 203.8 (ranging 185–240), 238.2 (ranging 220–270), and 259.25 (ranging 240–270) degrees, respectively. The mean grip strength of the injured hand was 66.14 and 86.1% of the uninjured hand at 6 weeks and 3 months postoperative. There was no nonunion, malrotation, or infection. In conclusion, single intramedullary K-wire fixation gives excellent outcomes in the treatment of single or multiple, simple, metacarpal shaft fractures without the need of postoperative immobilization.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Single Buried Intramedullary K-Wire Fixation in Nonthumb Metacarpal Shaft Fractures with Immediate Postoperative Mobilization without Any Immobilization

Siriwittayakorn,

Adulkasem,

Sangthongsil

et al. 2023

Advances in Orthopedics

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“…Even though many authors have reported successful clinical results with angles of between 30° and 70° according to oblique radiographs, Michel reviewed the neck fractures and revealed that 45° angulation can lead to important shortening of muscle resting length. [ 3 , 8 ] Therefore, we decided in our study to limit the angle to 40°.…”

Section: Discussionmentioning

confidence: 99%

Early movement does not cause loss of reduction in surgically treated boxer fractures

Uzun¹

2021

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The surgical treatment of fifth metacarpal fractures, especially using Kirschner (K) wire techniques, has recently become popular because it provides for early hand movement. Successful anatomical reduction of the fracture is often achieved with surgery; however, an anatomical reduction cannot always be achieved and, according to 30° oblique radiography, the fracture is fixed with an apex dorsal angulation below 40°. The aim of this study was to evaluate the stability of such fractures postoperatively and compare the two different angulation options that provide early movement of the hand and wrist. METHODS: Thirty consecutive cases of neck fractures of the fifth metacarpal were treated intramedullarly with one K wire. Cases were divided into two groups: One fixed with anatomical reduction (Group 1) and the other (Group 2) fixed in apex dorsal angulation below 40°, according to 30° oblique radiography. Angulation, shortening, and functional outcome as Quick DASH scores and grip strengths were evaluated at 6 months. RESULTS: The mean correction angle was 56.6° (between 30° and 110°) for Group 1 and the residual angle was 0°. The mean correction angle was 42.4° (between 20° and 75°) for group 2 (Figs. 4 and 5) and the residual angle was 23.6° (between 10° and 45°). The mean Quick DASH scores were 1.9 (SD: 1.7) for Group 1 and 5.67 (SD: 2.93) for Group 2 (p<0.05). Grip strength values were similar for both groups. All the patients returned to their previous occupations without any limitations in an average of 4 weeks (SD: 1.4) (range 2–6 weeks). No complications such as correction loosening or shortening were detected. Rotation was not detected during physical examination. CONCLUSION: Our investigation revealed no risk of shortening or rotation of the fracture; the patients were able to return quickly to their everyday activities.

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“…ESIN has been widely applied in the treatment of long bone fracture in children [11]. Moreover, the application of ESIN in FMNF produces satisfactory clinical function, and it could be performed in minimally invasive fashion [12,13].…”

Section: Introductionmentioning

confidence: 99%

Antegrade nailing using elastic stable intramedullary nail for fifth metacarpal neck fractures in adolescents: ultrasound versus fluoroscopy

Liu,

Wu,

Wang

et al. 2024

Preprint

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Introduction: Fractures of the fifth metacarpal neck (FMNF) represent a common hand injury, often amenable to conservative management. However, in adolescents with significant displacement or rotational deformity, surgical intervention may be warranted to achieve optimal functional recovery. This study aims to juxtapose the clinical outcomes of percutaneous pinning using Elastic Stable Intramedullary Nailing (ESIN) under fluoroscopic versus ultrasound guidance. Methods: We conducted a retrospective analysis encompassing 42 patients aged 10 to 16 diagnosed with FMNF. Patients were stratified into cohorts based on the modality employed for procedural guidance, distinguishing between those guided by ultrasound and fluoroscopy. Comprehensive demographic and clinical parameters were meticulously documented for both cohorts. Furthermore, the pre- and post-operative alterations in Horizontal Metacarpal Phalangeal Angle (HSA) and Metacarpal Phalangeal Joint Range of Motion (MPJ ROM) were meticulously scrutinized to ascertain surgical efficacy. Results: Notably, parameters such as Pre-operative HSA, Post-operative HSA, and MPJ ROM exhibited no statistically discernible disparities between the ultrasound-guided cohort and their fluoroscopy-guided counterparts (P > 0.05). Conclusions: Evidently, closed reduction coupled with percutaneous pinning under ultrasound guidance emerges as a viable therapeutic modality for adolescent FMNF cases. Importantly, it yields clinical outcomes commensurate with those achieved through percutaneous pinning conducted under fluoroscopy.

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A single antegrade intramedullary k-wire for fifth metacarpal neck fractures

Cited by 14 publications

References 32 publications

Single Buried Intramedullary K-Wire Fixation in Nonthumb Metacarpal Shaft Fractures with Immediate Postoperative Mobilization without Any Immobilization

Single Buried Intramedullary K-Wire Fixation in Nonthumb Metacarpal Shaft Fractures with Immediate Postoperative Mobilization without Any Immobilization

Early movement does not cause loss of reduction in surgically treated boxer fractures

Antegrade nailing using elastic stable intramedullary nail for fifth metacarpal neck fractures in adolescents: ultrasound versus fluoroscopy

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