Surgical treatment of fifth metacarpal neck fractures: antegrade intramedullary nailing versus transverse percutaneous pinning

BACKGROUND: To compare clinical and radiographic outcomes of antegrade intramedullary pinning (AIMN) and transverse percutaneous pinning (TPP) for the treatment of fifth metacarpal neck fractures.METHODS: A retrospective study was performed on patients surgically treated for a fifth metacarpal neck fracture be-tween 2009 and 2019. Sixty-three patients were included, divided into two groups according to the type of fixation: 33 pa-tients underwent surgery using antegrade intramedullary technique and 30 with transverse pinning. Clinical outcome was evaluated with DASH score, VAS, and active ROM. Volar angulation and shortening were determined on radiographs using DC-30 and SH-Stip methods, respectively. Healing time, return to work and complications were also assessed.RESULTS: Antegrade intramedullary pinning group showed significantly better outcome than transverse pinning in terms of DASH score, VAS score, return to work and fracture angulation. CONCLUSIONS: Antegrade intramedullary nailing provided better clinical and radiological outcomes than TPP. We found that AIMN technique resulted in better hand function, less residual pain and faster return to work. It also ensured a better fracture angulation correction.