Journal List > J Korean Fract Soc > v.20(1) > 1037619

Kim, Yoo, Kim, Lee, and Lee: Bouquet Pin Intramedullary Nail Technique of the 5th Metacarpal Neck Fractures

Abstract

Purpose

To evaluate radiologic and clinical results of bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture.

Materials and Methods

Between April, 2005 and February, 2006, 17 patients treated by bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture were evaluated. All patients were reviewed clinically and radiologically after operation.

Results

All of 17 cases of fractures were completely united. In the anteroposterior radiographs, the average of preoperative angulation was corrected from 34.4° to 5.2°. Also, in the oblique radiographs, radiographic results of angulation correction were satisfactory which was corrected from 44.2° to 11.7°. Although, the averages of difference between postoperative and final follow-up angulations were 1.5° in the anteroposterior radiographs and 0.9° in the oblique radiographs, they were not statistically different. All patients were excellent clinically except 1 patient who has moderate joint stiffness after operation.

Conclusion

Selecting of appropriate patients who is indicated, bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture could be a good treatment method without complications.

Figures and Tables

Fig. 1

Preparation for the entrance site of bouquet pin intramedullary nail technique. The exposure was carried out through a small incision at the ulnar aspect of the 5th metacarpal. Protecting dorsal cutaneous branch of ulnar nerve, a cortical window at the base of metacarpal was created (arrow).

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Fig. 2

Configuration of prebent K-wire. A K-wire was prebent to control pin direction (A) and to facilitate correction of rotational deformity (B).

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Fig. 3

(A) A 28-year old man sustained a 5th metacarpal neck fracture with 34° angulation deformity in anteroposterior radiograph and 54° angulation deformity in oblique radiograph.

(B) Postoperative radiographs show 0° and 14° residual angulation, respectively.
(C) A 5-month postoperative radiographs show good union without any reduction loss or rotational deformity.
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Table 1

Grading the results of bouquet pin intramedullary nail technique of the 5th metacarpal neck fractures

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From Kang et al.14) and Theeuwen et al.21)

Table 2

Radiographic angulations in patients with bouquet pin intramedullary nail technique of the 5th metacarpal neck fractures

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