Göker YURDAKUL, Muhammed KAZEZ
Journal of Medicine and Palliative Care - 2026;7(3):509-513
Aims: To compare clinical and radiological outcomes, operative parameters, and complication rates between titanium elastic nail (TEN) fixation and plate osteosynthesis in the treatment of fifth metacarpal neck fractures. Methods: This retrospective cohort study included 44 patients with extra-articular fifth metacarpal neck fractures (AO/OTA 77.5.2) treated surgically between January 2020 and March 2025. Twenty-three patients underwent TEN fixation and 21 underwent plate osteosynthesis. Preoperative angulation was measured on initial radiographs. Functional outcomes were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) score and metacarpophalangeal (MCP) joint range of motion at 6 months. Radiological union, reduction quality, operative time, fluoroscopy duration, and complications were evaluated. Rotational alignment was assessed clinically. Results: Preoperative angulation was similar between the groups (52+/-15 derece vs. 54+/-16 derece, p=0.156). Operative time and fluoroscopy duration were significantly lower in the TEN group (32.4+/-6.8 vs. 51.7+/-9.5 minutes and 4.2+/-1.5 vs. 8.6+/-2.4 seconds, respectively; p<0.001 for both). DASH scores and MCP joint range of motion were comparable (p>0.05). All fractures achieved radiological union with similar time to union (p=0.32). All cases demonstrated good reduction quality (<15 derece), and no rotational deformity was observed. Complications occurred only in the plate group, with no significant difference between groups. Conclusion: TEN fixation provides comparable clinical and radiological outcomes to plate osteosynthesis, with shorter operative and fluoroscopy times.
