Assessment of functional recovery in boxer’s fractures treated by bouquet technique and casting
DOI:
https://doi.org/10.71152/ajms.v16i11.4938Keywords:
Boxer’s fracture; Bouquet technique; Intramedullary K-wire; Cast immobilizationAbstract
Background: Fracture neck of the fifth metacarpal, also known as boxer’s fracture, is the most common metacarpal fracture, accounting for ~36% of cases. Treatment options vary from conservative immobilization to surgical fixation, but there is no clear consensus on the optimal approach.
Aims and Objectives: To compare the functional outcomes of boxer’s fractures treated with antegrade intramedullary bouquet K-wire fixation versus cast immobilization.
Materials and Methods: This prospective study was conducted at the Department of Orthopaedics, Chettinad Hospital and Research Institute, Kancheepuram, after approval by the Institutional Ethics Committee (Approval No: IHEC-1/2475/2). Thirty patients with a fracture neck of the fifth metacarpal were included and randomized into two groups: Group A (bouquet fixation, n=15) and Group B (cast immobilization, n=15). Patients were followed up for 6 months. Outcomes were assessed clinically and radiologically using grip strength, neck-shaft angle, QuickDASH score, and Visual Analog Scale (VAS) pain score.
Results: At 6 months, Group A showed superior outcomes compared to Group B: mean grip strength (107.5±9.4 vs. 82.3±19.3, P<0.001), neck-shaft angle (20.5°±2.5 vs. 24.3°±3.5, P<0.001), QuickDASH score (4.8±2.4 vs.10.2±3.1, P<0.001), and lower VAS scores (P=0.002). All fractures united radiologically within 12 weeks. Complications in Group A included pin tract infection (1 case) and K-wire migration (1 case), while malunion and hand stiffness were more frequent in Group B.
Conclusion: Antegrade bouquet K-wire fixation provides better functional and radiological outcomes with fewer complications compared to cast immobilization in boxer’s fractures. It is a minimally invasive, effective technique with a short learning curve and should be considered as a preferred option in young active patients.
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