Comparison of Antegrade Percutaneous Intramedullary K-wire Fixation and Transverse Pinning for Treatment of Unstable Displaced Metacarpal Neck and Shaft Fractures: A Prospective Interventional Study
Introduction: Metacarpal fractures account for upto 10% of all body fractures and 36% of all hand fractures in adolescents, young adults, and active adults. Among metacarpal fractures, fracture of the metacarpal shaft and neck are most common after direct trauma, roadside accidents, or sport...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2022-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/16739/56686_CE[AD]_F(SHU)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf |
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| author | Ansari Emad Yaqub Navneet Singh Punit Tiwari Sandeep Singh Jaura Bhupinder Singh Brar |
| author_facet | Ansari Emad Yaqub Navneet Singh Punit Tiwari Sandeep Singh Jaura Bhupinder Singh Brar |
| author_sort | Ansari Emad Yaqub |
| collection | DOAJ |
| description | Introduction: Metacarpal fractures account for upto 10% of all
body fractures and 36% of all hand fractures in adolescents, young
adults, and active adults. Among metacarpal fractures, fracture
of the metacarpal shaft and neck are most common after direct
trauma, roadside accidents, or sports injuries. The ratio of the
shaft to the neck is 1:2. Closed reduction and plaster of paris cast
can be used to treat the majority of these fractures conservatively.
Unstable and comminuted fractures necessitate surgery.
Aim: To compare the clinical, functional and radiological outcomes
in antegrade intramedullary fixation and transverse pinning of
metacarpal fractures in patients of unstable and displaced metacarpal
shaft and neck fractures.
Materials and Methods: A single-institutional prospective
interventional study identified 60 cases of metacarpal fractures
between November 2019 to August 2021 in the Maharishi
Markandeshwar Medical college and Hospital, Kumarhatti,
Himachal Pradesh, India. Each of the cases met the inclusion
criteria for closed extra-articular fractures, displaced and unstable
fractures of the metacarpal bone. The patients were divided into two groups having 30 subjects each, randomly allotted to
two groups (Antegrade intramedullary K-wiring and Transverse
Pinning). Outcomes were compared for range of movement by
the American Society of Hand Surgeons Total Active Motion
score (ASSH TAM), Visual Analog Scale (VAS), and radiological
parameters (Angulation). Patients were followed-up for 12 weeks.
Complications were listed in terms of pin site infection.
Results: Most of the patients were found to be in the third
decade of life. The fracture union was achieved at 8±2 weeks.
Clinical evaluation done by VAS score which was found to be
statistically insignificant between two groups (p-value=0.243).
Radiological assessment evaluated by measuring postoperative
angulation between two groups was found to be statistically
insignificant (p-value=0.248). Difference in functional evaluation
between the two groups done by ASSH TAM was found to
statistically significant between the groups (p-value=0.036).
Conclusion: Both antegrade intramedullary K-wiring and transverse
pinning demonstrate good and comparable results for extra-articular
neck and shaft metacarpal fractures. However, the former is superior
in terms of final range of motion as per ASSH TAM score. |
| first_indexed | 2024-04-10T09:21:45Z |
| format | Article |
| id | doaj.art-282ff0526ba547f3a096d5970cf288f7 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T09:21:45Z |
| publishDate | 2022-08-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-282ff0526ba547f3a096d5970cf288f72023-02-20T10:23:30ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-08-01168RC06RC1010.7860/JCDR/2022/56686.16739Comparison of Antegrade Percutaneous Intramedullary K-wire Fixation and Transverse Pinning for Treatment of Unstable Displaced Metacarpal Neck and Shaft Fractures: A Prospective Interventional StudyAnsari Emad Yaqub0Navneet Singh1Punit Tiwari2Sandeep Singh Jaura3Bhupinder Singh Brar4Senior Resident, Department of Orthopaedics, Maharishi Markandeshwar Medical College and Hospital, Solan, Himachal Pradesh, India.Associate Professor, Department of Orthopaedics, Maharishi Markandeshwar Medical College and Hospital, Solan, Himachal Pradesh, India.Associate Professor, Department of Orthopaedics, Maharishi Markandeshwar Medical College and Hospital, Solan, Himachal Pradesh, India.Assistant Professor, Department of Orthopaedics, Maharishi Markandeshwar Medical College and Hospital, Solan, Himachal Pradesh, India.Professor, Department of Orthopaedics, Maharishi Markandeshwar Medical College and Hospital, Solan, Himachal Pradesh, India.Introduction: Metacarpal fractures account for upto 10% of all body fractures and 36% of all hand fractures in adolescents, young adults, and active adults. Among metacarpal fractures, fracture of the metacarpal shaft and neck are most common after direct trauma, roadside accidents, or sports injuries. The ratio of the shaft to the neck is 1:2. Closed reduction and plaster of paris cast can be used to treat the majority of these fractures conservatively. Unstable and comminuted fractures necessitate surgery. Aim: To compare the clinical, functional and radiological outcomes in antegrade intramedullary fixation and transverse pinning of metacarpal fractures in patients of unstable and displaced metacarpal shaft and neck fractures. Materials and Methods: A single-institutional prospective interventional study identified 60 cases of metacarpal fractures between November 2019 to August 2021 in the Maharishi Markandeshwar Medical college and Hospital, Kumarhatti, Himachal Pradesh, India. Each of the cases met the inclusion criteria for closed extra-articular fractures, displaced and unstable fractures of the metacarpal bone. The patients were divided into two groups having 30 subjects each, randomly allotted to two groups (Antegrade intramedullary K-wiring and Transverse Pinning). Outcomes were compared for range of movement by the American Society of Hand Surgeons Total Active Motion score (ASSH TAM), Visual Analog Scale (VAS), and radiological parameters (Angulation). Patients were followed-up for 12 weeks. Complications were listed in terms of pin site infection. Results: Most of the patients were found to be in the third decade of life. The fracture union was achieved at 8±2 weeks. Clinical evaluation done by VAS score which was found to be statistically insignificant between two groups (p-value=0.243). Radiological assessment evaluated by measuring postoperative angulation between two groups was found to be statistically insignificant (p-value=0.248). Difference in functional evaluation between the two groups done by ASSH TAM was found to statistically significant between the groups (p-value=0.036). Conclusion: Both antegrade intramedullary K-wiring and transverse pinning demonstrate good and comparable results for extra-articular neck and shaft metacarpal fractures. However, the former is superior in terms of final range of motion as per ASSH TAM score.https://www.jcdr.net/articles/PDF/16739/56686_CE[AD]_F(SHU)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdfantegrade intramedullary k-wiringclosed reductionmetacarpal fractures |
| spellingShingle | Ansari Emad Yaqub Navneet Singh Punit Tiwari Sandeep Singh Jaura Bhupinder Singh Brar Comparison of Antegrade Percutaneous Intramedullary K-wire Fixation and Transverse Pinning for Treatment of Unstable Displaced Metacarpal Neck and Shaft Fractures: A Prospective Interventional Study Journal of Clinical and Diagnostic Research antegrade intramedullary k-wiring closed reduction metacarpal fractures |
| title | Comparison of Antegrade Percutaneous Intramedullary K-wire Fixation and Transverse Pinning for Treatment of Unstable Displaced Metacarpal Neck and Shaft Fractures: A Prospective Interventional Study |
| title_full | Comparison of Antegrade Percutaneous Intramedullary K-wire Fixation and Transverse Pinning for Treatment of Unstable Displaced Metacarpal Neck and Shaft Fractures: A Prospective Interventional Study |
| title_fullStr | Comparison of Antegrade Percutaneous Intramedullary K-wire Fixation and Transverse Pinning for Treatment of Unstable Displaced Metacarpal Neck and Shaft Fractures: A Prospective Interventional Study |
| title_full_unstemmed | Comparison of Antegrade Percutaneous Intramedullary K-wire Fixation and Transverse Pinning for Treatment of Unstable Displaced Metacarpal Neck and Shaft Fractures: A Prospective Interventional Study |
| title_short | Comparison of Antegrade Percutaneous Intramedullary K-wire Fixation and Transverse Pinning for Treatment of Unstable Displaced Metacarpal Neck and Shaft Fractures: A Prospective Interventional Study |
| title_sort | comparison of antegrade percutaneous intramedullary k wire fixation and transverse pinning for treatment of unstable displaced metacarpal neck and shaft fractures a prospective interventional study |
| topic | antegrade intramedullary k-wiring closed reduction metacarpal fractures |
| url | https://www.jcdr.net/articles/PDF/16739/56686_CE[AD]_F(SHU)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf |
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