Conservative treatment has comparable outcome with bouquet pinning of little finger metacarpal neck fractures: a multicentre randomized controlled study of 85 patients

Abstract

Current literature gives few guidelines regarding indication for operative treatment of little finger metacarpal neck fractures, and some surgeons choose operative treatment when the palmar angulation exceeds 30°. The objective of this study was to determine whether conservative treatment produces comparable outcomes with bouquet pinning in a randomized, controlled trial. Eighty-five patients with little finger metacarpal neck fractures with ≥30° palmar angulation in the lateral view were included. Patients were randomized to two groups: conservative treatment without reduction of the fracture (43 patients); and closed reduction and bouquet pinning (42 patients). After 1 year, there were no statistical differences between the groups in QuickDASH score, pain, satisfaction, finger range of motion, grip strength, or quality of life. There was a trend versus better satisfaction with hand appearance (p = 0.06), but longer sick leave (p < 0.001) and more complications (p = 0.02) in the operative group.

Comparison of AO Titanium Locking Plate and Screw Fixation versus Anterograde Intramedullary Fixation for Isolated Unstable Metacarpal and Phalangeal Fractures

“…The main complications of K‐wire fixation are migration of the K‐wires and malrotation of the digit, which requires surgical revision or conversion to ATLPS. To prevent these complications, a bouquet configuration of the wires has been suggested by Sletten et al and Foucher for treatment of fifth digit metacarpal neck fractures. Angled cross‐pinning and insertion of as many K‐wires as possible are recommended to prevent rotational instability and migration.…”

Osteosynthesis of fifth metacarpal neck fractures with a photodynamic polymer bone stabilization system

“…Patients with metacarpal neck fractures, as described by Sletten et al. (2014), with angular deformity ≥30°, lateral displacement or malrotation and a clinical and radiological follow up of 12 to 24 weeks were included in the study.…”

Clinical Reports: The Importance of Reporting a Surgeon’s Level of Expertise

“…Three recent articles deliver much clearer and scientifically sound information with the inclusion when reporting a challenging surgery 5 or results of comparative studies. 3,4 The goal of the publication in 2009 was to formulate a scoring method, 1 which can be used to indicate the expertise level of the surgeons of investigated techniques. Clarification of the proposed 5-point scale may be necessary for some practical situations (such as residents performing procedures under the instruction of attending surgeons 3 ).…”