Keywords : Boxer fracture
Functional outcome of Antegrade Intramedullary k-wire fixation for fifth metacarpal neck fracture
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 2203-2208
Background: The fracture of the fifth metacarpal neck (also called a boxer’s fracture) is the most common fracture of the hand. Displaced fractures often end in volar angulation of the metacarpal head, shortening, and residual malrotation. Although many fractures can be treated conservatively, surgery is indicated in patients with excessive volar angulation, relevant shortening, or rotational deformity.
Methods: In a prospective study conducted June 2019 to June 2021 we analysed the clinical results of 20 patients with metacarpal neck fractures that had been treated by closed reduction with intramedullary pre bent k-wires. Patients were followed at 2weeks, 6 weeks, 12 weeks for functional outcome and assessed by total active motion of affected and unaffected hand.
Results: Most of the patients were young, with good bone quality and low anaesthetic risk, and they had suffered the fractures as a result of a direct trauma. Predominantly uncomplicated. Surgical treatment was indicated for a palmar axis dislocation of >30° or if a rotatory deficiency >10° was present.
Metacarpophalangeal joint function and correction of rotatory displacement could be assessed on median after a period of six months. In all 20 patients flexion and extension was normal and comparable on both sides. All the patients have pain free range of motion, cosmetic acceptability, without any residual deformity and complete functional restoration.
Conclusion: Intramedullary k-wire fixation is a minimally invasive method for stabilizing metacarpal neck fractures. The excellent long-term clinical results are due to the fact that the gliding tissue around the fractures are not affected by the surgical procedure.