Early movement does not cause loss of reduction in surgically treated boxer fractures


UZUN M., Tetik C.

ULUSAL TRAVMA VE ACIL CERRAHI DERGISI-TURKISH JOURNAL OF TRAUMA & EMERGENCY SURGERY, cilt.28, sa.8, ss.1142-1147, 2022 (SCI-Expanded) identifier identifier identifier identifier identifier

Özet

BACKGROUND: This surgical treatment of fifth metacarpal fractures, especially using Kirschner (K) wire techniques, has recently become popular because it provides for early hand movement. Successful anatomical reduction of the fracture is often achieved with surgery; however, an anatomical reduction cannot always be achieved and, according to 30 degrees oblique radiography, the fracture is fixed with an apex dorsal angulation below 40 degrees. The aim of this study was to evaluate the stability of such fractures postoperatively and compare the two different angulation options that provide early movement of the hand and wrist. METHODS: Thirty consecutive cases of neck fractures of the fifth metacarpal were treated intramedullarly with one K wire. Cases were divided into two groups: One fixed with anatomical reduction (Group 1) and the other (Group 2) fixed in apex dorsal angulation below 40 degrees, according to 30 degrees oblique radiography. Angulation, shortening, and functional outcome as Quick DASH scores and grip strengths were evaluated at 6 months. RESULTS: The mean correction angle was 56.6 degrees (between 30 degrees and 110 degrees) for Group 1 and the residual angle was 0 degrees. The mean cor- rection angle was 42.4 degrees (between 20 degrees and 75 degrees) for group 2 (Figs. 4 and 5) and the residual angle was 23.6 degrees (between 10 degrees and 45 degrees). The mean Quick DASH scores were 1.9 (SD: 1.7) for Group 1 and 5.67 (SD: 2.93) for Group 2 (p<0.05). Grip strength values were similar for both groups. All the patients returned to their previous occupations without any limitations in an average of 4 weeks (SD: 1.4) (range 2-6 weeks). No complications such as correction loosening or shortening were detected. Rotation was not detected during physical examination. CONCLUSION: Our investigation revealed no risk of shortening or rotation of the fracture; the patients were able to return quickly to their everyday activities.