The Optimum Size of K-Wires for Fifth Metacarpal Neck Fractures: Double 1.6 mm K-Wires Antegrade Intramedullary Nailing Technique

Objective: Previous researches did not pay significant attention to the 5th metacarpal’s intramedullary diameter. This research aims to determine the optimal K-wires for 5th metacarpal neck fractures based on the narrowest part of 5th metacarpal. Methods: We retrospectively studied 31 patients with fifth metacarpal neck fractures. All patients underwent Intramedullary (IM) nailing surgery with two 1.6 mm K-wires. The narrowest part of the fifth metacarpal was measured preoperatively based on CT scan. Quick-DASH was assigned to be the primary outcome, pain, satisfaction, motor function and complications were also recorded. Results: Well reductions were observed in all patients. QuickDASH sore was median 0 with the range of 0-32, pain score was median 0 with the range of 0-2, VAS satisfaction was median 5 with the range of 3-5 at the endpoint. Grip strength, metacarpophalangeal joint and total active motion were improved immediately after operation. Two patients remained persistent paresthesia, and three patients experienced persistent pain at the endpoint with the VAS score of 1, 2, 2. Conclusion: The use of double 1.6 mm K-wires antegrade intramedullary nailing could be an optimum option for patients with fifth metacarpal neck fractures.