Background:Management of metacarpal fractures is decided by the stability and nature of the fracture. It may be conservative or surgical. Surgical management has a lot of techniques and different instruments, that make the surgeon confused which technique to use.
The purpose of the study was to treat unstable non-thumb metacarpal fractures with percutaneous K-wires fixation via Bouquet technique and evaluate its results.
Methods: This is retrospective study conducted in Benha University & Insurance hospitals on forty patients with metacarpal fractures that treated by Bouquet technique via antegrade intramedullary K wires . There were 26 males and 14 female patients with an average age of 30 years (range 19–42 years),with 28 dominant hand fractures , the 2nd MCB affected in 11 patients, 3rd MCB in 2 patients, 4th MCB in 10 patients, 5th MCB in 14 patients, while multiple metacarpal fractures in 3 patients.
Results: Mean follow up period 11.5 months (range from: 7 to 16) , average radiographic union was 7.7weeks (range 6–10 weeks) , average TAM was 248.75º (range from 170º-275º), and we have 28 patients with excellent results , 10 patients have good results and two patients with poor results according to Belsky assessment.
Conclusion:The Bouquet technique with flexible antegrade intramedulary nailing in metacarpal fractures is a simple and safe method with less invasive feature on soft tissues , and have the superiority in neck ,head and Boxer’s fractures than other methods of
fixation , but have no significant difference of the outcomes between it and mini-plates in oblique and spiral fractures. |
