gms | German Medical Science

Objectives/Interrogation: Percutaneous pinning is used to maintain reduction of the Bennett fracture. However, it is unclear whether surgeons have to pass the K-wire through metacarpal bones. The purpose of this study is to compare the radiological outcomes of treating Bennett fractures with the K-wires passing or not passing the first metacarpals and the middle of the trapeziometacarpal joint.

Methods: From Jan 2014 to May 2017, a total of 28 patients with Bennett fractures were treated by percutaneous pinning with two K-wires. The fracture was reduced manually after traction and reduction under fluoroscopy. Thirteen patients were randomly chosen to have their first K-wires pass through the first metacarpal base to the trapezium and 15 patients were chosen to have their first K-wires passing lateral to the metacarpal base inserting only to the trapezium. After inserting the first K-wire in different ways, we inserted the second K-wires in the same fashion, from the first to the second metacarpal in all the patients. The K-wires were removed four or five weeks after surgery. We assessed the radiographic outcomes of two groups one year after surgery with plain radiographs (anteroposterior, oblique and lateral views).

Results and Conclusions: In both groups, there was no loss of reduction during the period of pinning fixation and no re-displacement of fracture after removal of the K-wires. Statistically, there is no difference in the timing of K-wire removal, the time required to completely heal the fracture and joint congruency (p > 0.05). Radiographically, we found all patients in two groups healed without any difference in reduction. Both methods maintained reduction well and did not show loss of reduction during the pinning periods.

We conclude that the surgeon does not need to pass the K-wire through the first metacarpal base to achieve reliable fracture reduction of Bennett fractures.