Closed Antegrade/Retrograde intramedullary fixation of central metatarsal fractures: Surgical technique and clinical outcomes.

Abstract

Intramedullary fixation with k-wires is a surgical option in the management of fractures of the shaft and neck of central metatarsals. The current study aimed at investigating the clinical outcomes of closed antegrade/retrograde intramedullary pinning technique. A total of 34 patients (26 males and eight females) with 58 metatarsal neck and shaft fractures (28 shaft and 26 neck fractures) were operated using the antegrade/retrograde intramedullary fixation technique. At the final follow-up visit, pain intensity was assessed using the visual analog scale (VAS) and foot function was evaluated by the American Orthopedic Foot and Ankle Society (AOFAS) forefoot scoring system. Mean follow-up period was 18 months, ranged 12 to 34. Mean time to clinical fracture healing was 6.5 weeks, ranged 5 to 9. Bony union was occurred in all the cases. No surgical site infection was noted. Mean VAS score at the final follow-up visit was 0.28, ranged 0 to 3. At the final follow-up, the mean AOFAS score was 95.2, ranged 81 to 100. Closed antegrade/retrograde intramedullary pinning is a minimally invasive technique to manage central metatarsal fractures. Using this technique, metatarsal alignment can be restored and good clinical outcome is achieved.