• Eur J Trauma Emerg Surg · Apr 2024

    Randomized Controlled Trial Comparative Study

    Conservative treatment versus transverse pinning in fifth metacarpal neck fractures in active adults: a randomized controlled trial.

    • Sherif Hamdy Zawam, Begad Hesham Abdelrazek, Aly Elmofty, Ahmed Morsy, and Mahmoud Abousayed.
    • Department of Trauma and Orthopedics, Faculty of Medicine, Cairo University, Giza, Egypt. sherif88@kasralainy.edu.eg.
    • Eur J Trauma Emerg Surg. 2024 Apr 1; 50 (2): 531542531-542.

    PurposeCompare two simple ways for treating boxer's fractures in active adults; conservative management by ulnar gutter slab and transverse pinning in fixation of fifth metacarpal's neck fracture regarding union, functional outcomes, and complications.Patients And MethodsNinety patients with fifth metacarpals' neck fractures with palmar angulation (30-70°) were managed either conservatively by an ulnar gutter slab or surgically by transverse pinning technique from January 2020 to December 2021. Only 84 patients completed a 1-year follow-up. Patients with old, open, or mal-rotated fractures were excluded. The block-randomization method was used to create equal groups. Patients were evaluated clinically and radiologically every 2-3 weeks until union, then at 6 and 12 months. Functional assessment at the final visit was done using the quick DASH score, total active motion (TAM), and total Active Flexion (TAF).ResultsThe mean radiological union time for the conservative group in this study was 7.76 weeks, while for the transverse pinning group, it was 7.38 weeks. There was no statistically significant difference between the two techniques regarding union rates and functional outcomes. All patients returned to their pre-injury jobs and level of activity.ConclusionBoth conservative management in ulnar gutter slab and percutaneous transverse pinning are considered effective methods in the treatment of simple extra-articular fifth metacarpal neck fractures with angulation between 30 and 70 degrees (AO: 77 A3.1). The functional and radiological results using both methods were satisfactory and statistically comparable.© 2023. The Author(s).

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