Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Zahra Street, Achrafieh, Beirut, Lebanon.
Eur J Trauma Emerg Surg. 2020 Apr;46(2):389-395. doi: 10.1007/s00068-018-01073-2. Epub 2019 Jan 7.
Antegrade intramedullary nailing (AIMN) using 2k-wires seems to be superior to other modalities in treating displaced fractures of the fifth metacarpal neck (FFMN). Few reports demonstrated similar results retrospective with a single k-wire. The aim of the study is to describe our single k-wire technique and evaluate the related results.
This is a retrospective study of a continuous series of patients treated with a single intramedullary k-wire for FFMN. It includes 30 patients who met the criteria for surgery: a dorsal angulation of more than 30°, malrotation, or both. The mean clinical follow-up period was 7 ± 14.9 months.
The mean pre-operative angle was 50° ± 11.35° and the mean immediate post-operative angle was 4.86° ± 2.8°. The mean immediate correction was 47° ± 9.3°. The mean correction at last follow-up was 45.14° ± 8.55°. Healing was obtained in all patients and bone union was achieved at a mean of 5.6 ± 1.2 weeks. The mean operative time was 8.5 min. The mean C-arm usage (number of clicks) was 7.2 times. The mean exposure radiation time was calculated at 3.6 s. The mean radiation dose was 0.08 mGy/mm. The mean satisfaction score was 1.26 ± 0.45. Quick-DASH and EQ-5D scores yielded excellent values.
With potential benefits like lesser surgical time, radiation and cost, the use of a single AIMN could be safer, quicker and cheaper while reproducing similar clinical, functional and radiological outcomes to those reported with the use of 2k-wires.
使用 2k 线的顺行髓内钉（AIMN）似乎在治疗第五掌骨颈（FFMN）移位骨折方面优于其他方法。很少有报道使用单根 K 线回顾性地显示出类似的结果。本研究的目的是描述我们的单根髓内 K 线技术并评估相关结果。
这是一项连续系列使用单根髓内 K 线治疗 FFMN 的患者的回顾性研究。它包括 30 名符合手术标准的患者：背侧成角大于 30°、旋转移位或两者兼有。平均临床随访时间为 7 ± 14.9 个月。
术前平均角度为 50°±11.35°，术后即刻平均角度为 4.86°±2.8°。平均即刻矫正角度为 47°±9.3°。末次随访时的平均矫正角度为 45.14°±8.55°。所有患者均获得愈合，骨愈合时间平均为 5.6±1.2 周。手术时间平均为 8.5 分钟。平均 C 臂使用（点击次数）为 7.2 次。平均曝光辐射时间为 3.6 秒。平均辐射剂量为 0.08mGy/mm。平均满意度评分为 1.26±0.45。Quick-DASH 和 EQ-5D 评分均获得优异值。
使用单根 AIMN 具有手术时间、辐射和成本较低等潜在优势，在复制与使用 2k 线相似的临床、功能和影像学结果的同时，可能更安全、更快、更便宜。
