Antegrade intramedullary fixation of displaced fifth metacarpal fractures

Calder, James; O’Leary, Stephen; Evans, Stuart

doi:10.1016/s0020-1383(99)00201-6

Cited by 28 publications

(32 citation statements)

References 11 publications

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“…These techniques include retrograde pinning (RP) by means of intramedullary K-wires, transverse pinning (TP) using K-wires, external fixation and standard or low-profile plates (7)(8)(9). However, complications including marked angulation accompanied by potential reduction in the range of motion (ROM) and reduced grip strength (10,11) may occur.…”

Section: Introductionmentioning

confidence: 99%

Outcome of antegrade intramedullary fixation for juvenile fifth metacarpal neck fracture with titanium elastic nail

Shen

Cao

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The purpose of the current study was to assess the outcome of antegrade intramedullary fixation with titanium elastic nail (TEN) in displaced fifth metacarpal neck fractures. The present study included 69 consecutive juvenile patients with displaced fifth metacarpal fractures. The head-shaft angle of the fifth metacarpal and range of motion (ROM) of the metacarpophalangeal (MCP) joint were evaluated. A disabilities of the arm, shoulder and hand (DASH) questionnaire was used to assess upper arm function. The head-shaft angle of the affected side was significantly improved postoperatively (P<0.05). No marked difference was observed between the affected and unaffected side in head-shaft angle and ROM. The average DASH score was 1.7 (range, 0-6.0). All patients obtained anatomical reduction postoperatively and the average healing time was 5.7±1.09 weeks (range, 5-10 weeks) with no non-union cases. Therefore antegrade intramedullary fixation with TEN is recommended as an easy, reliable and minimally invasive surgical technique for treating displaced fifth metacarpal neck fractures.

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Section: Introductionmentioning

confidence: 99%

Outcome of antegrade intramedullary fixation for juvenile fifth metacarpal neck fracture with titanium elastic nail

Shen

Cao

et al. 2017

Experimental and Therapeutic Medicine

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“…As reported by the authors themselves, this is a very difficult surgical technique, which requires a long learning curve. Neither Calder et al 12 nor…”

Section: Discussionmentioning

confidence: 94%

“…In agreement with other authors, we believe that retrograde fixation of the fifth metacarpal bone may cause MP joint stiffness, with a frequent limitation of the extension of the fifth finger, due to the trauma of the extensor hood and the collateral ligaments during the wire insertion. 12 The limitations of our study are that it is a retrospective study which included a relatively small number of patients, without a control series of patients treated with a different method. However, on the basis of our final results, we believe that transverse pinning fixation to the intact fourth metacarpal bone for displaced boxer's fractures is a valid and easy surgical technique, with minimised surgical trauma.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, they reported a case of avascular necrosis of the metacarpal head in the same series. In a short-term review, with a mean follow-up of 9 months, Calder et al 12 reported excellent results in six patients treated for displaced boxer's fractures, stabilised by a modified anterograde intramedullary pin. We disagree with this treatment because we believe that by using only one K-wire, although modified, the risk of a secondary rotational displacement of the fracture is extremely high.…”

Section: Discussionmentioning

confidence: 99%

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Fractures of the neck of the fifth metacarpal bone. Medium-term results in 28 cases treated by percutaneous transverse pinning

Potenza

Caterini

Maio

et al. 2012

Injury

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Fractures of the metacarpal bones are very common injuries of the skeletal system and, in approximately 50% of the cases, involve the neck of the fifth metacarpal bone. These fractures are frequently observed in active young men, occur in the dominant hand and are typical injuries of aggression (boxer's fractures). [1][2][3] Surgical treatment is mandatory for severely displaced and unstable fractures to avoid impairment of hand function. In fact, malrotation or volar angulation of the metacarpal head may frequently cause reduction in the grip strength and lack of full extension of the fifth finger.3-7 The results of surgical treatment seem to be influenced by the preoperative condition of the soft tissues of the hand; therefore, in fractures associated with softtissue injuries, most authors suggest minimising the surgical trauma so as to obtain better results. 3,6 Berkman and Miles 8 first described transverse wire fixation to intact metacarpals for treatment of unstable fractures of the metacarpal bones. The purpose of this retrospective study was to report the medium-term results in 28 patients affected by displaced fracture of the neck of the fifth metacarpal (boxer's fracture), with an associated severe swelling of the surrounding soft tissues, who were treated by percutaneous transverse pinning.8 Materials and methodsIn a pool of 88 consecutive fractures of the metacarpals surgically treated at our hospital between 2004 and 2008, 44 were displaced fractures of the neck of the fifth metacarpal bone (boxer's fracture). At diagnosis, 35 of these fractures showed a severe swelling of the surrounding soft tissues; they were treated by closed reduction and percutaneous transverse K-wire pinning. All 35 patients were invited to our hospital for a clinical and radiological follow-up, but only 28 were able to return for examination. There were 25 male and three female patients; the right hand was involved in 24 cases and the left in four. The average age of the patients was 38.4 years (range 15-71 years). The mechanism of trauma was a direct blow in 25 patients and a scooter accident in three. In all patients, a rotational deformity of the fifth finger and/or a palmar angulation of the fracture 308 were present. Rotational displacement of the fifth ray was The purpose of this study was to report the medium-term results in 28 patients affected by closed displaced fractures of the neck of the fifth metacarpal bone (boxer's fracture) with an associated severe swelling of the hand, who were treated with percutaneous transverse K-wire pinning, to verify the effectiveness of this surgical treatment. We opted for this treatment in all cases in which malrotation of the fifth finger and volar angulation of the metacarpal head greater than 308 were associated with a severe swelling of the hand. All the patients were reviewed clinically and radiologically at an average of 25 months after surgery. At the final follow-up, no patient reported residual pain. All patients had full extension of the fifth finger, except two in whom ...

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“…Subsequently the French, German and English literatures have reported favorable results comparable to our series. [4,6,11,20,21,25,37,38,41,44,45] Other authors have successfully employed this technique in other metacarpal fractures as well. [21,25,26,41,45] Our indications for internal fixation surgery had been; displaced or unstable fractures of metacarpal necks, open fractures with soft tissue trauma and patients unwilling to accept the cosmetic deformity resulting from non operative treatment.…”

Section: Surgical Techniquementioning

confidence: 99%

“Bouquet technique” for displaced boxers fracture: Surgical technique and outcomes in143 consecutive cases

Memon

Patankar

Nagori

2018

Int Jour of Biomed Res

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Background: Fifth metacarpal neck fractures, also known as Boxer's fractures, commonly occur as a result of axial impact on a clenched fist. There is no agreement over the optimum management of undisplaced boxers fracture. We present the results of treatment by a Bouquet technique, described by Foucher in 143 consecutive cases of displaced fifth metacarpal neck fractures. Methods: We retrospectively reviewed our records for 143 consecutive cases of fifth metacarpal neck fractures treated with Bouquet technique. Clinical and radiological evaluation was done at 6 weeks, 12 weeks and 6 months. Total active motion of the fifth digit, radiography and complications if any were noted. Results: Of 143 cases, there were 113 cases with closed reduction and 30 with open reduction. Radiological union was achieved in 140 cases. Remaining 3 were lost to follow up. Good to excellent result was achieved in 95% cases. Seven cases developed bursitis at the K-wire entry site which required k-wire removal. Conclusion:The technique of flexible antegrade intramedulary nailing of fifth metacarpal neck fractures is simple, safe, soft tissue sparing, minimally invasive technique giving excellent functional and cosmetic results with minimal complications.

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Antegrade intramedullary fixation of displaced fifth metacarpal fractures

Cited by 28 publications

References 11 publications

Outcome of antegrade intramedullary fixation for juvenile fifth metacarpal neck fracture with titanium elastic nail

Outcome of antegrade intramedullary fixation for juvenile fifth metacarpal neck fracture with titanium elastic nail

Fractures of the neck of the fifth metacarpal bone. Medium-term results in 28 cases treated by percutaneous transverse pinning

“Bouquet technique” for displaced boxers fracture: Surgical technique and outcomes in143 consecutive cases

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