Comparison of Conservative and Closed Reduction Percutaneous Pinning Methods for the Treatment of 5th Metacarpal Neck Fractures

Introduction: This study aimed to evaluate the clinical and radiological outcomes of conservative treatment and closed reduction with anterograde pinning for the treatment of 5th metacarpal (MC) neck fractures. Methods: Data of patients who underwent surgery for 5th MC neck fractures between January...

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Main Authors: Mesut Karıksız, Mehmet Fatih Erol
Format: Article
Language:English
Published: Galenos Yayinevi 2023-11-01
Series:İstanbul Medical Journal
Subjects:
Online Access: http://istanbulmedicaljournal.org/archives/archive-detail/article-preview/comparison-of-conservative-and-closed-reduction-pe/63660
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author Mesut Karıksız
Mehmet Fatih Erol
author_facet Mesut Karıksız
Mehmet Fatih Erol
author_sort Mesut Karıksız
collection DOAJ
description Introduction: This study aimed to evaluate the clinical and radiological outcomes of conservative treatment and closed reduction with anterograde pinning for the treatment of 5th metacarpal (MC) neck fractures. Methods: Data of patients who underwent surgery for 5th MC neck fractures between January 2017 and December 2020 were retrospectively analyzed. Two groups were formed: those treated with closed reduction and anterograde intramedullary Kirschner wire fixation and those treated with closed reduction and casting. The groups were statistically compared in terms of pre- and post-treatment radiological angulation, functional outcomes, and return to work times. Quick-Disability of Arm, Shoulder and Hand Outcome Measure and visual analog scale (VAS) were used for functional scoring. Results: The study included 33 patients (6 male, 27 female) treated conservatively and 32 patients (4 male, 28 female) treated with closed reduction and anterograde percutaneous pinning. In the closed reduction and casting group, the post-treatment angulation was measured as 19 degrees (10-30). In the anterograde pinning group, the post-treatment angulation was 15 degrees (9-20). At the end of the first year, 5th MC joint flexion was measured as 75 degrees (30-100) in group 1 and 75 degrees (50-100) in group 2. The DASH score was 0 (0-25) in group 1 and 0 (0-40) in group 2. The VAS score was 96 (18-100) in group 1 and 100 (30-100) in group 2. Conclusion: The results of this study suggest that intramedullary Kirschner wire fixation is a safe option for treating 5th MC neck fractures. In addition, an increase in angulation was observed after closed reduction even in cases where acceptable limits of angulation were maintained. While emphasizing the need for more comprehensive research, this study also suggests that surgical treatment could be effective in different angulations.
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spelling doaj.art-7ab5b7e45425421fba854f039059e0f72023-11-30T12:44:52ZengGalenos Yayineviİstanbul Medical Journal2619-97932148-094X2023-11-0124437938310.4274/imj.galenos.2023.0105713049054Comparison of Conservative and Closed Reduction Percutaneous Pinning Methods for the Treatment of 5th Metacarpal Neck FracturesMesut Karıksız0Mehmet Fatih Erol1 University of Health Sciences Turkey, Başakşehir Çam and Sakura Training and Research Hospital, Clinic of Orthopedic and Traumatology, İstanbul, Turkey Private Vega Hospital, Clinic of Orthopedic and Traumatology, Tekirdağ, Turkey Introduction: This study aimed to evaluate the clinical and radiological outcomes of conservative treatment and closed reduction with anterograde pinning for the treatment of 5th metacarpal (MC) neck fractures. Methods: Data of patients who underwent surgery for 5th MC neck fractures between January 2017 and December 2020 were retrospectively analyzed. Two groups were formed: those treated with closed reduction and anterograde intramedullary Kirschner wire fixation and those treated with closed reduction and casting. The groups were statistically compared in terms of pre- and post-treatment radiological angulation, functional outcomes, and return to work times. Quick-Disability of Arm, Shoulder and Hand Outcome Measure and visual analog scale (VAS) were used for functional scoring. Results: The study included 33 patients (6 male, 27 female) treated conservatively and 32 patients (4 male, 28 female) treated with closed reduction and anterograde percutaneous pinning. In the closed reduction and casting group, the post-treatment angulation was measured as 19 degrees (10-30). In the anterograde pinning group, the post-treatment angulation was 15 degrees (9-20). At the end of the first year, 5th MC joint flexion was measured as 75 degrees (30-100) in group 1 and 75 degrees (50-100) in group 2. The DASH score was 0 (0-25) in group 1 and 0 (0-40) in group 2. The VAS score was 96 (18-100) in group 1 and 100 (30-100) in group 2. Conclusion: The results of this study suggest that intramedullary Kirschner wire fixation is a safe option for treating 5th MC neck fractures. In addition, an increase in angulation was observed after closed reduction even in cases where acceptable limits of angulation were maintained. While emphasizing the need for more comprehensive research, this study also suggests that surgical treatment could be effective in different angulations. http://istanbulmedicaljournal.org/archives/archive-detail/article-preview/comparison-of-conservative-and-closed-reduction-pe/63660 5th metacarpal neck fracturepercutaneous pinningconservative treatmentclosed reduction
spellingShingle Mesut Karıksız
Mehmet Fatih Erol
Comparison of Conservative and Closed Reduction Percutaneous Pinning Methods for the Treatment of 5th Metacarpal Neck Fractures
İstanbul Medical Journal
5th metacarpal neck fracture
percutaneous pinning
conservative treatment
closed reduction
title Comparison of Conservative and Closed Reduction Percutaneous Pinning Methods for the Treatment of 5th Metacarpal Neck Fractures
title_full Comparison of Conservative and Closed Reduction Percutaneous Pinning Methods for the Treatment of 5th Metacarpal Neck Fractures
title_fullStr Comparison of Conservative and Closed Reduction Percutaneous Pinning Methods for the Treatment of 5th Metacarpal Neck Fractures
title_full_unstemmed Comparison of Conservative and Closed Reduction Percutaneous Pinning Methods for the Treatment of 5th Metacarpal Neck Fractures
title_short Comparison of Conservative and Closed Reduction Percutaneous Pinning Methods for the Treatment of 5th Metacarpal Neck Fractures
title_sort comparison of conservative and closed reduction percutaneous pinning methods for the treatment of 5th metacarpal neck fractures
topic 5th metacarpal neck fracture
percutaneous pinning
conservative treatment
closed reduction
url http://istanbulmedicaljournal.org/archives/archive-detail/article-preview/comparison-of-conservative-and-closed-reduction-pe/63660
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