Feasibility study of arthroscopically-assisted K-wire internal fixation for fifth metacarpal neck fractures

Li Jinxing; Zhou Feng; Sheng Wei

doi:10.3969/j.issn.1009-4237.2025.11.009

Abstract：Objective To investigate the clinical efficacy of arthroscopically-assisted K-wire internal fixa-tion in the treatment of fifth metacarpal neck fractures.Methods A retrospective analysis was conducted on 17 pa-tients with fifth metacarpal neck fractures treated in our department using arthroscopically-assisted K-wire internal fixation between Mar.2022 and Mar.2024.This cohort included 13 males and 4 females,aged 22-59 years(mean 38.2 years).Injury mechanisms included clenched-fist trauma(12 cases),road traffic injuries(2 cases),machine crush injuries at work(2 cases),and ground-level falls(1 case).All patients underwent surgery within one week post-injury.Intraoperatively,continuous traction reduction was applied using an arthroscopic tower,and percutaneous pinning was performed under fifth metacarpophalangeal joint arthroscopic guidance for accurate positioning and di-rection.After satisfactory fluoroscopic confirmation,the K-wire ends were bent and left exposed externally.The op-eration time,fluoroscopy frequency,and K-wire insertion attempts were recorded.At 4 weeks postoperatively,radio-graphic union was assessed,and internal fixation was removed as appropriate.Pain was evaluated using the visual analog scale/score(VAS),while joint and hand function were assessed using the total active movement(TAM)and the Michigan hand outcomes questionnaire(MHQ).Results The 17 patients were followed up for 6-24 months(mean 13.5 months).Mean operation time was(30.7±5.8)min,with intraoperative fluoroscopy of(4.3±1.7)times and K-wire insertion attempts of(3.2±1.3)times.No postoperative complications such as fixation failure or wound infection occurred.K-wires were removed at 4-5 weeks postoperatively(mean 4.4 weeks).At the 6-month follow-up,TAM was excellent in 15 cases and good in 2 cases,yielding an excellent-good rate of 100%.The mean MHQ score was(94.2±2.7)points.Conclusion The arthroscopically-assisted K-wire internal fixation for fifth metacarpal neck fractures offers advantages of minimal invasion,rapid and safe operation,quick postoperative func-tional recovery,and few complications.This technique is worthy of further clinical promotion.