Outcome and prognosis of Antegrade intramedullary nancy nail for fifth metacarpal neck fractures (box fracture)versus retrograde k wire: a systematic review and meta-analysis

Abstract

Antigrade One of the mainstays for surgically treating neck and metacarpal shaft fractures is intramedullary nancy nail fixation. Nevertheless, there is still a dearth of research comparing the results of the several surgical repair methods that are available for all indicated metacarpals. In order to examine the clinical benefits and limitations of IMKW in comparison to alternative fracture repair procedures, we carried out a systematic review and meta-analysis. To find research that compared the clinical results of IMKW to alternative metacarpal fixation techniques, a thorough systematic literature study was conducted. Results included visual analog scale pain, union rate, grip strength, complications, operational time, and Disabilities of the Arm, Shoulder, and Hand (DASH/quick DASH) scores. IMKW was compared to the pooled effect of alternative fixation methods using a random-effects model. Our analysis includes 10 studies with a total of 497 metacarpal fractures (220 shafts and 277 necks). In every study, IMKW fixation was designated as the control group. Plates, transverse K-wires (TKWs), interfragmentary screws (IFSs), and K-wire cross-pinning (CP) were all part of the combined experimental group. IMKW demonstrated a considerably reduced operating time for treating metacarpal shaft fractures (p = 0.04; mean difference = - 13; 95% CI = -26 to -0.64). When treating metacarpal neck fractures, no appreciable variations were seen in terms of disability, grip strength, healing rate, pain, operating time, or complication rate. The clinical results of different surgical approaches for treating neck and metacarpal shaft fractures were not observed to differ in this comprehensive review and meta-analysis. In order to treat closed, unstable metacarpal fractures, further high-quality research is needed to compare the safety and effectiveness of intramedullary screws, TKW, CP, and IFS to IMKW. Aim of the study:-  We investigated the outcomes of the antegrade intramedullary nailing (AIMN) compared to retrograde k.wire in the treatment for fifth metacarpal neck fractures via a systematic review.

Keywords: Antigrade, fractures, metacarpal neck