Background: Fractures of the 5th metacarpal bone areone of the common injuries that are presented to the hand surgeon. Surgical intervention is required for restoration of function and cosmoses when dealing with certain unstable fracture patterns,displaced and angulated fractures, open injuries, Percutaneous fixation could be applied to 5th metacarpal fractures because the bone has subcutaneous access for insertion of K-wires.Aim of the work: To evaluate the effectiveness of syringe external fixation method in the management of 5thmetacarpals fractures of the hand.Patients and methods: Aprospective study held from January 2013 to January 2014in Benha University Hospital. Twenty patients having unstable 5thmetacarpal fractures were included in the study. The mechanism of injury were fighting (boxer fracture), road traffic accidents, fall on the ground and industrial crush injuries. Inclusion criteria were irreducible or unstable fracture, rotational deformity, comminuted fractures and open fractures. 16 patients were males, and 4 patients were females with mean age of 34.3 years (±9.5 years). In 12 patients the right hand was affected while in 8 patients fracture affect the left hand. 12 patients have neck fracture, 4 patients have shaft fracture and 4 patients have comminuted fracture.Result: Fracture healed within 6-8 weeks. The mean follow up period was 8 month (5-12 month). At the final follow-up, the mean TAM was 230°. The mean grip strength of injured hand 90% of the non-injured side strength, average Quick Dash score was 6 (±3.5). 15 patients were very satisfied (75%) and 5 patients were satisfied (25%).The mean visual analogue score for pain was 1.5. One patients presented superficial pin tract infection at the site of K-wire insertion 3 patients united with mild angulation of the 5th metacarpal.Conclusion: Treatment of unstable fracture of the 5th metacarpal bone using syringe fixator is a good option with low cost and good functional outcome |
