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

Abstract

Objectives

Antegrade intramedullary nailing (AIMN) using 2k-wires seems to be superior to other modalities in treating displaced fractures of the fifth metacarpal neck (FFMN). Few reports demonstrated similar results retrospective with a single k-wire. The aim of the study is to describe our single k-wire technique and evaluate the related results.

Methods

This is a retrospective study of a continuous series of patients treated with a single intramedullary k-wire for FFMN. It includes 30 patients who met the criteria for surgery: a dorsal angulation of more than 30°, malrotation, or both. The mean clinical follow-up period was 7 ± 14.9 months.

Results

The mean pre-operative angle was 50° ± 11.35° and the mean immediate post-operative angle was 4.86° ± 2.8°. The mean immediate correction was 47° ± 9.3°. The mean correction at last follow-up was 45.14° ± 8.55°. Healing was obtained in all patients and bone union was achieved at a mean of 5.6 ± 1.2 weeks. The mean operative time was 8.5 min. The mean C-arm usage (number of clicks) was 7.2 times. The mean exposure radiation time was calculated at 3.6 s. The mean radiation dose was 0.08 mGy/mm2. The mean satisfaction score was 1.26 ± 0.45. Quick-DASH and EQ-5D scores yielded excellent values.

Conclusions

With potential benefits like lesser surgical time, radiation and cost, the use of a single AIMN could be safer, quicker and cheaper while reproducing similar clinical, functional and radiological outcomes to those reported with the use of 2k-wires.

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Correspondence to Kaissar Yammine.

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Conflict of interest

All named authors (Chahine Assi, Jad Mansour, Camille Samaha, Sleiman Ajjoub, Kaissar Yammine) hereby declare that they have no conflicts of interest to disclose.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Assi, C., Mansour, J., Samaha, C. et al. A single antegrade intramedullary k-wire for fifth metacarpal neck fractures. Eur J Trauma Emerg Surg 46, 389–395 (2020). https://doi.org/10.1007/s00068-018-01073-2

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Keywords

  • Fifth metacarpal neck fracture
  • Single antegrade elastic nailing
  • Surgery