Comparative study between Antegrade Intramedullary K-wires Fixation versus Transfixing K-wires of the 5th Metacarpal Neck Fractures

Abstract

The neck of the 5th metacarpal fractures ‘‘Boxer Fractures’’ are so common fractures of the hand . Mostly, the dominant hand is affected as common mode of trauma is punching .The appropriate treatment for a Boxer’s fracture varies based on whether the fracture is open or closed, the degree of angulation and rotation .The majority of closed Boxer’s fractures treated conservatively. But surgery is preferred for those have palmar angulation exceeds 30o , malrotation , Irreducible or shortening >3 mm. This study aims to compare clinical and radiological results and the complication rates after reduction and fixation of closed Boxer fractures using antegrade intramedullary versus percutaneous Transfixing K wires. Forty adult patients above fifteen with closed isolated Boxer fracture were included in a prospective comparative randomized study. Twenty patients treated with percuaneous transfixing K wires &others treated with antegrade intramedullary K wires . Ulnar gutter splint was done for 2 weeks postoperatively. Early range of motion is allowed after 2 weeks . Removal of transfixing K wires done after one and half month postoperatively. But were buried under the skin in other group . Follow-up of mean 6 months for radiographic and clinical results in clauses of union time and rate, complication rate, range of motion and power of hand grip . Radiographic and clinical outcomes showed no statistical dissimilarity in union time, rate of complications , postoperative pain, range of motion and power of hand grip. Both techniques are comparable and simple techniques with no significant complications.