Abstract
Closed reduction and internal fixation with antegrade intramedullary nails is a feasible and effective treatment for displaced fifth metacarpal neck fractures (FMNFs). The present study aimed to compare clinical and radiological outcomes in patients with displaced FMNFs after treatment with single or dual antegrade elastic intramedullary nails (AEIMNs). Thirty-three patients were treated with a single 2.0 mm AEIMN and 34 patients were treated with two 1.5 mm AEIMNs. Clinical and radiological outcomes included grip strength, active range of motion (ROM), active flexion and extension of the fifth metacarpophalangeal (MCP) joint, dorsal angulation loss, and metacarpal shortening of the fifth metacarpal at 12 months after treatment. No significant difference was observed between the two groups with respect to grip strength, ROM or flexion of the fifth MCP joint. The average values of dorsal angulation loss, metacarpal shortening, and extension of the fifth MCP joint of the dual nails group were better than those of the single nail group (dorsal angulation loss, 2.79 ± 1.93° vs. 4.05 ± 1.59°, P = 0.009; metacarpal shortening, 1.66 ± 0.80 mm vs. 2.12 ± 0.88 mm, P = 0.028; extension of the fifth MCP joint, 7.71 ± 4.43° vs. 4.82 ± 4.09°, P = 0.012). In conclusion, dual AEIMNs fixation provided better MCP extension and radiological outcomes than single AEIMN fixation.
Highlights
Closed reduction and internal fixation with antegrade intramedullary nails is a feasible and effective treatment for displaced fifth metacarpal neck fractures (FMNFs)
Severe palmar displacement and shortening or rotational deformity of the fifth metacarpal fracture may result in a considerable decrease in grip strength and range of motion (ROM), and surgical treatment is recommended for such c ases[4,5]
Various techniques are available for treating FMNFs, including closed reduction with percutaneous pinning, antegrade or retrograde intramedullary nailing, open reduction and internal fixation with plates and/or screws, and transverse pinning with k-wires[4,5,7,8,9,10]
Summary
Closed reduction and internal fixation with antegrade intramedullary nails is a feasible and effective treatment for displaced fifth metacarpal neck fractures (FMNFs). The present study aimed to compare clinical and radiological outcomes in patients with displaced FMNFs after treatment with single or dual antegrade elastic intramedullary nails (AEIMNs). Yammine et al.[12] reported that antegrade intramedullary nailing provided better clinical and radiological outcomes than percutaneous transverse pinning or miniplate fixation in their meta-analysis of treatment procedures for FMNFs. The features of internal fixation, including the number and diameter of the nail, are associated with the stability of Hospital, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China. FMNFs were surgically treated with a closed reduction and percutaneous antegrade intramedullary nailing fixation with single or dual elastic nails. The authors evaluated whether the number of nails affected the stability of elastic intramedullary nailing fixation and the clinical and radiological outcomes
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