Management of Fifth Metacarpal Neck Fracture (Boxer's Fracture): A Literature Review

Hussain, Malik Hatim; Ghaffar, Ali; Choudry, Q; Iqbal, Zafar; Khan, Muhammad Noman

doi:10.7759/cureus.9442

Cited by 19 publications

(26 citation statements)

References 32 publications

(55 reference statements)

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“…The operative management choice and metalwork products for the metacarpal neck fractures were increased as the surgical technology and internal fixation products developed. 4 Many studies compared different modalities of surgical treatment to weight out the best in the light of the improvement of materials and instruments, and better understanding of biomechanical principles of internal fixation [23,24].…”

Section: Discussionmentioning

confidence: 99%

“…Intramedullary fixation has been a classical procedure for treating metacarpal and phalangeal fractures; various techniques and types of instrumentation have been proposed to improve postoperative functional recovery and ROM. These include various forms of Kirschnerwire (K-wire) pinning (antegrade intramedullary K-wire, retrograde intramedullary K-wire, transverse pinning with K-wire, retrograde cross pinning with K-wire) [3,4], extramedullary fixation with plates and screws [5] and external fixation [6].…”

Section: Introductionmentioning

confidence: 99%

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Multiple Intramedullary Nailing Versus Low Profile Mini-Plating in Unstable Metacarpal Neck Fractures

Aboelnaga

Ramadan

Quolquela

et al. 2021

JAMMR

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Background: Neck fractures of the metacarpal bone can alter optimal hand function. Many surgical fixation techniques are described for this fracture with no robust evidence for the best treatment. Recently developed low profile plates may, however, challenge the preference for K-wires. Low profile plates were found to have lower complications than conventional plates in addition to early range of motion and early return to work. The aim of the present study was to determine the best outcome in patients with unstable fracture neck metacarpals using either multiple K wires or low profile mini-plating. Methods: This prospective randomized controlled study included 37 patients suffering from metacarpal neck fractures. patients were designated as group 1 (AIN group; 18 patients), and the other consecutive patients were designated as group 2 (LPP group; 19 patients). Both groups were treated within the first 48 hours of their injury and followed up for a minimum period of 40 weeks; the maximum period of follow up was 48 weeks. Results: No significant differences were found for PVAS, Q-DASH, TAM, time to radiological union or residual deformities at last follow-up. Grip strength, however, was significantly better in the K-wire group. Operative time and time off work were significantly shorter in the k-wire group. Plate group showed prevalent complications both peri and post-operative hitting 63.2 % of the plate group vs 16.7% in K-wire group. Conclusions: Low profile plates with immediate mobilization paradoxically prolonged operative time, technical demand and disturbing the fracture’s biological environment along with the extra cost were thus not justified by results. Antegrade intramedullary K-wire nailing was superior for the management of unstable metacarpal neck fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multiple Intramedullary Nailing Versus Low Profile Mini-Plating in Unstable Metacarpal Neck Fractures

Aboelnaga

Ramadan

Quolquela

et al. 2021

JAMMR

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“…These fractures are more common in males and young adults (4). Such fractures are often managed conservatively using an ulnar gutter splint or strapping; howev-er, shortening of the metacarpus by more than 3 mm, angulation by more than 30 degrees, and rota-tional deformities are indications for surgical fixation (1)(2)(3)(4)(5). Several techniques are currently available for the surgical treatment of the fifth metacarpal neck fracture, including crossed pinning with Kirschner (K)-wire, antegrade intramedullary K-wire, retrograde intramedullary K-wire, retrograde crossed pinning with K-wire, transverse pinning with K-wire, external fixation, and plate fixation (1)(2)(3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

“…The decision of which surgical method to use all depends on the surgeon's preference, considering both the pros and cons of each method and the pathoanatomy of each case (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

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

Fidan

Çetin

2022

Journal of Health Sciences and Medicine

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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.

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Physical and Radiographic Examination of the Adult Hand

D’Antonio¹,

Murthy²

2023

Pediatric and Adult Hand Fractures

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Management of Fifth Metacarpal Neck Fracture (Boxer's Fracture): A Literature Review

Abstract: Hussain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 19 publications

References 32 publications

Multiple Intramedullary Nailing Versus Low Profile Mini-Plating in Unstable Metacarpal Neck Fractures

Multiple Intramedullary Nailing Versus Low Profile Mini-Plating in Unstable Metacarpal Neck Fractures

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

Physical and Radiographic Examination of the Adult Hand

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