• Chahine Assi, Jad Mansour, Camille Samaha, Sleiman Ajjoub, and Kaissar Yammine.
• 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 1; 46 (2): 389-395.

ObjectivesAntegrade 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.MethodsThis 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.ResultsThe 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/mm2. The mean satisfaction score was 1.26 ± 0.45. Quick-DASH and EQ-5D scores yielded excellent values.ConclusionsWith 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.

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