8/7/2023 0 Comments Define meta in metacarpal![]() ![]() Patients meeting any of the following criteria were excluded: any injuries on tendons, ligaments, vessels, and nerves on the ipsilateral upper limbs multi-fragmentary fractures, open fractures, or noncooperative patients. Inclusion criteria were as follows: patients over 18 years of age who had an isolated FMNF (≤ 14 days), dorsal angulation of the metacarpal neck of ≥ 30°, or presence of rotational deformity of the fifth finger upon flexion. Between February 2012 to July 2018, 78 patients with isolated displaced FMNFs were treated with closed reduction and percutaneous antegrade elastic intramedullary nailing (Double Medical Technology INC, Xiamen, China). Informed consent was obtained from all donors. This retrospective study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Zhuhai People’s Hospital. The authors evaluated whether the number of nails affected the stability of elastic intramedullary nailing fixation and the clinical and radiological outcomes. In this study, FMNFs were surgically treated with a closed reduction and percutaneous antegrade intramedullary nailing fixation with single or dual elastic nails. However, to the best of our knowledge, no previous studies have compared both single and dual elastic intramedullary nailing techniques in terms of the stability of fixation and clinical and radiological outcomes. The features of internal fixation, including the number and diameter of the nail, are associated with the stability of fixation and therefore may further affect the secondary displacement and prognosis. 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. Recently, the use of single or dual antegrade elastic intramedullary nailing (AEIMN) has gained increasing interest because it is relatively simple, causes minimal trauma, is cosmetically acceptable, reduces the risk of soft tissue adhesions, and shows good to excellent clinical outcomes 4, 11, 12, 13, 14. In general, the surgical technique should be able to minimize soft tissue disruption and allow early motion of the hand 8. The goal of surgical treatment is to restore hand function, and not to simply heal the hand as observed in normal radiographs. However, there is as yet no consensus on the most ideal technique of fixation. 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. Cadaveric studies suggest that metacarpal head angulations greater than 30° result in dysfunction of small finger motion at the metacarpophalangeal (MCP) joint 6. However, 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 cases 4, 5. The majority of FMNFs are simple and closed and are generally treated with conservative methods 3. In conclusion, dual AEIMNs fixation provided better MCP extension and radiological outcomes than single AEIMN fixation.įifth metacarpal neck fractures (FMNFs) are considered the most common type of hand fractures they account for approximately 20% of all fractures in the hand and are more common in males 1, 2. 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. No significant difference was observed between the two groups with respect to grip strength, ROM or flexion of the fifth MCP joint. 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. Thirty-three patients were treated with a single 2.0 mm AEIMN and 34 patients were treated with two 1.5 mm AEIMNs. 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). Closed reduction and internal fixation with antegrade intramedullary nails is a feasible and effective treatment for displaced fifth metacarpal neck fractures (FMNFs). ![]()
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