Biplab Chatterjee1 , Divyanshu Kumar2 , Tarak Chandra Halder 3
BACKGROUND Fifth metacarpal neck fractures, also known as Boxer’s fractures, commonly occur as a result of axial impact on a clenched fist. It can be managed both operatively and conservatively. We present the results of treatment by antegrade nailing, in 25 consecutive cases of fifth metacarpal neck fractures. METHODS We did a follow-up of 25 consecutive cases of fifth metacarpal neck fractures treated with antegrade nailing. Clinical and radiological evaluation was done at 2 weeks, 4 weeks, 6 weeks and 6 months. Total active motion (TAM) of the fifth digit at 6 weeks, radiography and complications if any were noted. Pain score by VAS was done for 5th digit at the end of 6 weeks. RESULTS Of 25 cases, there were 23 cases with closed reduction and 2 with open reduction. Radiological union was achieved in 24 cases and remaining 1 was lost to follow up. Good to excellent result was achieved in 100% cases. 3 cases developed bursitis at the K-wire entry site which required K-wire removal. 1 case had K wire migration making TAM less at 6 weeks follow up. CONCLUSIONS The technique of flexible antegrade intramedullary nailing of fifth metacarpal neck fractures is simple, safe, soft tissue sparing, minimally invasive technique giving excellent functional and cosmetic results with minimal complications.
