Trends in the Management of Fifth Metacarpal Neck Fractures

Luciani, Michael A.; Mayers, Yeshuwa; Warnick, Eugene; Udoeyo, Idorenyin F.; Klena, Joel C.; Grandizio, Louis C.

doi:10.1016/j.jhsa.2022.08.008

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…Management of isolated FNMF includes closed reduction with casting, closed reduction with percutaneous pinning (CRPP) or nailing, open reduction with plating [2][3][4][5][6][7][8][9][10]. Although surgery with various techniques has been reported, nonsurgical treatment remains a preferred choice for patients without signi cant angulation and mal-rotation [1,2]. The severity of angulation and the indication for surgery remains controversial [3,4].…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

“…Fifth metacarpal neck fracture (FMNF) is a common injury in hands, and most of this injury could be treated conservatively without prominent functional de cit [1,2]. However, in adolescents with severe displacement or rotation, surgery might be warranted for satisfactory functional recovery [3,4].…”

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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“…Twenty-one percent of patients never attended a follow-up visit. No nonoperatively managed patient had a subsequent surgical procedure for nonunion or malunion 40 .…”

Section: Metacarpal Fracturementioning

confidence: 99%

What’s New in Hand Surgery

Bohn

2024

Journal of Bone and Joint Surgery

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“…For metacarpal fractures that are angled at >30 or rotated, particularly those with a poor blood supply to the injured epiphysis, reduction surgery is required to avoid deformity during fracture healing and damage to the flexion, extension, and grasping functions of the hand. 4 Kirschner wire (K-wire) fixation is one of the most commonly performed treatments for metacarpal fractures in adolescents. An advantage of K-wire fixation in adolescents is the ease of performing the operation.…”

Section: Introductionmentioning

confidence: 99%

“…For metacarpal fractures that are angled at >30° or rotated, particularly those with a poor blood supply to the injured epiphysis, reduction surgery is required to avoid deformity during fracture healing and damage to the flexion, extension, and grasping functions of the hand. 4 …”

Section: Introductionmentioning

confidence: 99%

Treatment of fifth metacarpal neck fracture in adolescents with minimally invasive surgery: percutaneous Kirschner wire fixation versus elastic stable intramedullary nailing

Wang

Deng

et al. 2023

J Int Med Res

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Objective This retrospective study compared two minimally invasive surgical methods for fifth metacarpal neck fractures in adolescents: percutaneous Kirschner wire (K-wire) fixation and elastic stable intramedullary nailing (ESIN). Methods This study involved 42 adolescents aged 11 to 16 years with fifth metacarpal neck fractures treated by either K-wire fixation (n = 20) or ESIN (n = 22). The palmar tilt angle and shortening were compared on radiographs preoperatively and 6 months postoperatively. Total active range of motion (TAM), the visual analogue scale score for pain, and the Disabilities of the Arm, Shoulder and Hand score for upper limb function were recorded at 5 weeks, 3 months, and 6 months postoperatively. Results The mean TAM was significantly greater in the ESIN than K-wire group at all postoperative time points. The mean external fixation time was 2 weeks longer in the K-wire than ESIN group. One patient in the K-wire group developed infection. There was no statistically significant difference between the two groups in other postoperative outcomes. Conclusions ESIN fixation has the advantages of greater stability, better activity, a shorter external fixation time, and a lower infection rate than K-wire fixation in the treatment of fifth metacarpal neck fractures in adolescents.

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Trends in the Management of Fifth Metacarpal Neck Fractures

Cited by 5 publications

References 34 publications

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

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

What’s New in Hand Surgery

Treatment of fifth metacarpal neck fracture in adolescents with minimally invasive surgery: percutaneous Kirschner wire fixation versus elastic stable intramedullary nailing

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