Treatment of Fifth Metacarpal Neck Fractures with Antegrade Single Elastic Intramedullary Nailing

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2017 Jun 4

PMID 28577350

Citations 9

Authors

Yuanshi She

Youjia Xu

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to investigate clinical outcomes of fifth metacarpal neck fractures using antegrade single elastic nail and to explore ideal puncture point to avoid iatrogenic ulnar nerve injury.

Methods: A single elastic nail with suitable diameter was used in 27 cases of fifth metacarpal neck fractures with dorsal angulation over 45°. An initial entry point was perforated at the ulnar-dorsal base of the metacarpal. The nail was inserted in an antegrade approach. The nail was usually removed at about 5 weeks postoperatively.

Results: At final follow up, all fractures proceeded to bony union. The mean total passive motion was 285° and the mean total active motion (TAM) was 270°. The mean angulation decreased from 50.2 ± 6.3° preoperatively to 7.4 ± 2.3° postoperatively (p < 0.001). The mean DASH-Score was 2.1 ± 3.6 points after surgery. Two cases of skin irritation and one case of the dorsal cutaneous branch of the ulnar nerve (DCBUN) injury were observed. Superficial wound infections were not observed.

Conclusions: Collectively, antegrade single elastic intramedullary nailing was a minimally invasive and reliable fixation technique for fifth metacarpal neck fractures with dorsal angulation over 45°. Appropriate puncture position helped to reduce nerve damage.

Citing Articles

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Treatment of fifth metacarpal neck fracture in adolescents with minimally invasive surgery: percutaneous Kirschner wire fixation versus elastic stable intramedullary nailing.

Wang K, Du W, Deng C, Hu N, Zhuang W J Int Med Res. 2023; 51(5):3000605231174981.

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Early movement does not cause loss of reduction in surgically treated boxer fractures.

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Antegrade intramedullary fixation for adolescent fifth metacarpal neck fracture and its impact on epiphyseal growth.

Fan X, Wang J, Zhang D, Mao F, Liao Y, Xiao R BMC Musculoskelet Disord. 2021; 22(1):546.

PMID: 34130660 PMC: 8204464. DOI: 10.1186/s12891-021-04436-w.

Single versus dual elastic nails for closed reduction and antegrade intramedullary nailing of displaced fifth metacarpal neck fractures.

Zeng L, Zeng L, Miao X, Chen Y, Liang W, Jiang Y Sci Rep. 2021; 11(1):1778.

PMID: 33469102 PMC: 7815815. DOI: 10.1038/s41598-021-81242-3.

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