Surgical use of intramedullary k-wires in the fixation of fifth metacarpal neck fracture

This is a study report of 20 patients, having fracture of fifth metacarpal neck, also called as Boxer’s fracture, treated with closed reduction with JHASS maneuver and internal fixation with two antegrade intramedullary K-wires, to verify the functional outcomes with this treatment modality. All patients were followed up at least for six months (range 6-12 months, mean 8.85 months). Radiological outcomes were assessed based on AP and Oblique roentgenograms. All patients had bone union and underwent removal of K-wires in outpatient department at the end of 4 weeks. Pre-operative mean angular deformity was 61.750 (range 430 to 730) which was corrected to acceptable level; post-operative mean angular deformity was 18.050 (range 150 to 200). Patients were assessed for functional outcomes at the end of six months using Mayo wrist score. At the end of six months of follow up 18 patients (90%) had excellent functional outcome whereas 2 patients (10%) had good functional outcome. No patient had poor or fair functional outcome. None of the patients had post-operative rotational deformity. 1 patient developed superficial skin infection which was treated with oral antibiotics. We recommend this treatment modality for the treatment of Boxer’s fracture, as it is percutaneous, day care and easy to perform procedure with excellent functional outcomes, with minimal complications.