The 5th Metacarpal Neck Fracture Treated by Closed Reduction and Percutaneous Intramedullary K-wire Fixation

Choi, Soo Joong; Lee, Young Ho; Chang, Ho Guen; Lee, Chang Ju; Cho, Won Ho

Abstract

The fifth metacarpal neck fractures are unstable and often heals with angulation and deformity. So, after closed reduction and immobilization with splint or cast, they have often been lost reduction and healed with posterior angulation and cosmetic deformity. We conducted a prospective study of 11 patients who underwent percutaneous retrograde intramedullay K-wire fixation for a fracture of the neck of the fifth metacarpal during four years period. We used a closed reduction technique derived from Jahss maneuver or three point fixation maneuver. And, the fracture was maintained with two cross or parallel smooth intramedullary K-wire. The proximal side of K-wire was placed back wound side near the wrist joint. The last follow up (postoperative 14±2 weeks) radiographic results were dorsal angualtion 7±4 , corresponded to preoperative 48±7 , and immediately postoperative 6±4 The complications such as limitation of movement, increase of dorsal angulation, rotational malalignment, shortening, and depression of the head of metacarpal were not occurred. Rotational deformity was always well controlled. Correction of angulation was good and K-wire insertion and fixation technique were easy. We recommend this technique in case of over 40 dorsal angulation of fracture site due to absence of contact between the palmar fractured ends, and patients who dont accept the cosmetic deformity or want early exercise.