Open Reduction for the 5th Metacarpal Neck Fracture

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Journal of the Korean Society for Surgery of the Hand 2007;12(1):11-16.
Published online March 1, 2007.

Ho-Jung Kang, Sung-Hoon Jung, Yoon-Jin Choi, Chang-Wook Han, Soo-Bong Hahn

제5중수골 경부 골절의 관혈적 정복

강호정, 정성훈, 최윤진, 한창욱, 한수봉

Abstract

Purpose
To evaluate the treatment results of open surgery in the 5th metacarpal neck fracture by retrospective analysis. Materials and Methods: From March 1996 to May 2004, 15 patients who underwent open surgery due to the 5th metacarpal neck fracture were retrospectively reviewed with radiographic and functional analysis. We used the visual analog satisfaction score (0~10) to assess the patient’s subjective satisfaction and the assessment categories including pain, limitation of motion, hand deformity, and function. Patients gave each assessment category 10 points as the best score, and we analyzed the results with a total of 40 points. For open reduction, posterolateral approach was used with the 5th extensor tendon retracted to the ulna or radial side, and then fracture site reduction was done. Results: There were malunion in 4 cases, rotational deformity in 2 cases, redisplacement after closed reduction in 6 cases, displaced intraarticular fracture in 2 cases, and open fracture in 1 case. Patient subjective satisfaction score was an average of 34.6 points (29~38 points). Average dorsal angulation was 50.2˚(41˚~ 72˚) in the preoperative oblique radiographs and 18.4˚(15˚~41˚) at the last follow up. Conclusion: Open surgery should be recommanded for the treatment of the 5th metacarpal neck fracture in cases of malunion, rotational deformity, unstable and redisplaced fracture, displaced intrarticular fracture, and displaced growth plate injury.

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