Comparison Of Functional Outcome of Metacarpal Fractures Treated by Anterograde Vs Retrograde Approach of Intramedullary Pinning

  • Kag R Post graduate student
  • Shukla R
  • Chandrawanshi Y
Keywords: Metacarpal fractures, anterograde pinning, retrograde pinning, functional recovery, grip strength

Abstract

Purpose: Metacarpal fractures are a common injury, constituting a significant portion of upper extremity fractures. The purpose of this study is to compare the functional and radiological outcomes of anterograde vs. retrograde intramedullary pinning in the treatment of shaft metacarpal fractures. Methodology: This prospective study was conducted from February 2021-September 2022, involving 60 patients aged 18-65 years with closed, displaced metacarpal fractures. 30 patients received anterograde and another 30 received retrograde intramedullary pinning. Follow-up assessments were done at 2, 4, 6, and 12 weeks. Radiological and clinical outcomes were evaluated using TAM score, grip strength measurements, VAS scores, and standard radiographic analyses. Results: Mean age of patients in anterograde group was 34.60±7.35 years, while the retrograde group had a mean age of 32.53±8.80 years. The anterograde group demonstrated significantly higher grip strength at both 6 and 12 weeks postoperatively (p-value<0.0001) and lower VAS scores for pain at 2 and 6 weeks (p-value<0.0001). Radiological union was achieved faster in the anterograde group (mean union time=5.21 weeks) compared to the retrograde group (6.89 weeks). Stiffness was the most common complication, observed in 16.7% of the anterograde group and 23.3% of the retrograde group. The anterograde group also showed a higher percentage of patients achieving excellent results (46.4% vs. 23.4% in the retrograde group). Conclusion: Anterograde intramedullary percutaneous pinning is a superior technique compared to retrograde pinning for the management of metacarpal fractures. It offers faster functional recovery, better grip strength, and reduced pain in the early postoperative period, with fewer complications.

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Published
2024-12-12
How to Cite
1.
Kag R, Shukla R, Chandrawanshi Y. Comparison Of Functional Outcome of Metacarpal Fractures Treated by Anterograde Vs Retrograde Approach of Intramedullary Pinning. ojmpc [Internet]. 2024Dec.12 [cited 2024Dec.21];30(2):67-2. Available from: https://ojmpc.com/index.php/ojmpc/article/view/188
Issue
Vol 30 No 2 (2024): Jul-Dec
Section
Original Article

Copyright (c) 2024 Dr. Rishabh Kag, Dr. Rajeev Shukla, Dr. Yashraj Chandrawanshi

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