Abstract
Objective This study aims to evaluate the outcome after the internal fixation of diaphyseal metacarpal fractures by a single intramedullary K-wire. Methods In this prospective case series study, conducted from July 2017 to June 2019 in 23 adult patients with a single, unstable, diaphyseal metacarpal fracture, outcomes after internal surgical fixation using a single antegrade intramedullary K-wire were evaluated. The outcomes were evaluated by union rate, time to union, handgrip measurements at 6 and 12 months, and the modified Disabilities of the Arm, Shoulder, and Hand (DASH) score at 12 months. Results The study population consisted of 17 males and 6 females, with a mean patient age of 28.4 ± 8.5 years (range, 16–45 years). The median time to final follow-up was 14 ± 1.8 months (range: 12–24 months). The mean duration of the union was 7.3 ± 1.6 weeks (range: 5–11 weeks), with a union rate of 95.7% (22 cases). The mean handgrip strength was 68% ± 12.8% of the strength of the uninjured hand after 6 months and 92.7% ± 6.9% after 12 months. The mean modified DASH score was 2.6 ± 0.26 after 12 months (range: 0–5.8). There were no cases of malrotation or infection. In conclusion, using a single 1.8–2.0 mm K-wire gives excellent functional outcomes and union rate without significant complications when used to treat an unstable metacarpal shaft fracture.
Highlights
Metacarpal fractures are the third most common upper limb injury in young adults. when combined with phalangeal fractures, they are the most common upper limb injury [1, 2]
Men and young adults are more vulnerable to these injuries, as are people of low socioeconomic status [1]. e leading mechanisms of injury are direct trauma and sports trauma [1, 2]
A case series study was conducted to evaluate the outcome of single antegrade intramedullary K-wire fixation on displaced metacarpal fractures within 2 weeks of the initial injury. is study included 23 consecutive patients treated from July 2017 to June 2019
Summary
Metacarpal fractures are the third most common upper limb injury in young adults. when combined with phalangeal fractures, they are the most common upper limb injury [1, 2]. Metacarpal fractures are the third most common upper limb injury in young adults. When combined with phalangeal fractures, they are the most common upper limb injury [1, 2]. Diaphyseal metacarpal fractures cause marked angulation and shortening, impeding the function of extensor and flexor tendons [3,4,5]. Ad hoc technological instruments (e.g., plates) often are preferred as opposed to K-wires because they are supposed to fix the fracture better. In adult upper limb fractures, a safe and effective fixation can be obtained with smooth wires and rods with very good functional outcome [18,19,20]
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