European Journal of Trauma and Emergency Surgery | 2019
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\u2009±\u200914.9 months. Results The mean pre-operative angle was 50°\u2009±\u200911.35° and the mean immediate post-operative angle was 4.86°\u2009±\u20092.8°. The mean immediate correction was 47°\u2009±\u20099.3°. The mean correction at last follow-up was 45.14°\u2009±\u20098.55°. Healing was obtained in all patients and bone union was achieved at a mean of 5.6\u2009±\u20091.2 weeks. The mean operative time was 8.5\xa0min. The mean C-arm usage (number of clicks) was 7.2 times. The mean exposure radiation time was calculated at 3.6\xa0s. The mean radiation dose was 0.08\xa0mGy/mm 2 . The mean satisfaction score was 1.26\u2009±\u20090.45. 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.