Management of boxers fracture with single antegrade bent K-wire

Sadiq, Mohammed; Hussain, Syed Azher

doi:10.18203/issn.2455-4510.intjresorthop20191031

Cited by 3 publications

(2 citation statements)

References 16 publications

(24 reference statements)

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“…However, there is no agreement. Some use a true lateral view (Amsallem et al., 2018; Strub et al., 2010), some a 25° pronated view (Sadiq and Hussain, 2019), others a 30° supinated view (Poumellec and Dreant, 2017) or a 30° pronated view (Kaynak et al., 2019; Kim and Kim, 2015; Surke et al., 2020; Wong et al., 2015). Leung et al.…”

Section: Discussion About Review Resultsmentioning

confidence: 99%

“…Especially palmar angulation has been intensively debated. While many use an angulation threshold of 40° or even 60° (Cepni et al., 2016; Chen et al., 2020; Eldridge and Apau, 2015; Elmowafy et al., 2018; Facca et al., 2010; Fujitani et al., 2012; Kaynak et al., 2019; Kim and Kim, 2015; Ozturk et al., 2008; Pogliacomi et al., 2017; Potenza et al., 2012; Poumellec and Dreant, 2017; Rhee et al., 2012; Sadiq and Hussain, 2019; She and Xu, 2017), still a maximal angulation of 30° has been the guideline in many recent studies (Amsallem et al., 2018; Galal and Safwat, 2017; Kim and Kim, 2015; Surke et al., 2020; Tank et al., 2018; Winter et al., 2007; Wong et al., 2015). Rotational deformity must also be taken in account, although this rarely is a problem with neck fractures of the fifth metacarpal.…”

Section: Introductionmentioning

confidence: 99%

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Challenging the dogma: severely angulated neck fractures of the fifth metacarpal must be treated surgically

Boeckstyns

2020

J Hand Surg Eur Vol

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Cadaveric studies suggest that the acceptable deformity in fifth metacarpal neck fractures is maximally 30° palmar angulation. This systematic review verifies the validity of these threshold values. Eighteen prospective comparative studies on operative and/or conservative treatment options in adults were included. None of the studies demonstrated any correlation between the residual or initial angulation and the clinical results despite accepting more severe angular deformities. Closed reduction and immobilization without internal fixation improved the palmar angle by 5° to 9° in three studies and 29° in a fourth. Operative treatments compared with non-reducing conservative treatments showed no benefit of the surgery other than aesthetic issues. The synthesis of this review indicates that 90% of fractures of the metacarpal neck with apex angulation up to 70° can be treated successfully with a functional metacarpal brace without reduction. Disability of the Arm, Shoulder and Hand questionnaire scores <10 are uniformly reported. I modified my own practice accordingly a decade ago to treating these fractures conservatively regardless of the palmar angulation, except in patients with exceptional demands or other fracture deformities.

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Section: Discussion About Review Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Challenging the dogma: severely angulated neck fractures of the fifth metacarpal must be treated surgically

Boeckstyns

2020

J Hand Surg Eur Vol

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The Conservative Treatment of Some Hand and Carpal Fractures

Boeckstyns¹

2022

Hand Clinics

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Comparison of Results Based on the Number of Kirschner Wires of Different Diameters in Antegrade Intramedullary Fixation of Fifth Metacarpal Neck Fractures

Lee¹,

Park²,

Koh³

et al. 2021

Arch Hand Microsurg

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Purpose: The purpose of this study was to compare the clinical and radiological results of patients with fifth metacarpal neck fractures using different sizes and numbers of Kirschner wires (K-wire).Methods: A single institutional retrospective review identified 67 patients with a fifth metacarpal neck fracture between January 2015 and July 2020. The minimum follow-up time was 6 months and they were all treated within 6.4 days of the initial injury. Either one K-wire (1.6 mm), two K-wires (1.1 mm), or three K-wires (0.9 mm) was used. We analyzed the bone union period, and K-wire removal period, duration of surgery, total active motion, intramedullary diameter, pre/postoperative shortening, and pre/postoperative angulation clinically. We used a Method of Shortening Stipulated to measure shortening and the Medullary Canal-lateral view method for angulation. The intramedullary diameter was measured in the mid-shaft of the fifth metacarpal bone in the coronal view. Total active motion was measured at the time of follow-up in our outpatient department.Results: Clinical and radiological parameters showed no statistically significant differences. Even though it did not present a statistical significance, the absolute mean duration of surgery was the shortest in a single K-wire group. Conclusion: The clinical and radiological outcomes of surgery were comparable regardless of the number of K-wires inserted. However, we could look forward to gaining potential benefit from shortened operation time in a single K-wire group. Since stable fixation can be obtained even if one K-wire is used, inserting one thick K-wire into the intramedullary canal can be an alternative according to the surgeon’s preference.

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Management of boxers fracture with single antegrade bent K-wire

Cited by 3 publications

References 16 publications

Challenging the dogma: severely angulated neck fractures of the fifth metacarpal must be treated surgically

Challenging the dogma: severely angulated neck fractures of the fifth metacarpal must be treated surgically

The Conservative Treatment of Some Hand and Carpal Fractures

Comparison of Results Based on the Number of Kirschner Wires of Different Diameters in Antegrade Intramedullary Fixation of Fifth Metacarpal Neck Fractures

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