Early Results of Bouquet Technique in Treatment of Metacarpal Fractures.

Introduction: Metacarpal fractures are frequent, and many of them can be managed non-surgically with the proper reduction and immobilisation. As with any hand fracture, the major goals are to achieve anatomic and stable reduction, bone union, and early mobilisation. Objective: The aim of the present study was to evaluate the outcome of bouquet technique in management of unstable metacarpals fractures as isolated or multiple shaft metacarpal fractures, irreducible or unstable fracture, greater than 30 degree fracture angulation, greater than 10 degree rotational deformity, and extensive (more than 5 mm) metacarpal shortening. Patients and Methods: A prospective follow up study was carried out on 20 patients with metacarpal factures, managed at El Qureen Hospital, Dar Elhekmah Hospital and Abo Khalifa Emergency Hospital, A total of 17 males and 3 females with unstable 2nd to 5th metacarpal fractures fixed by intramedullary k-wires (Bouquet osteosynthesis) were recruited. Results: The average Quick DASH score was 1.45 (SD 1.23), ranging from zero to four points, and the mean grip strength of the damaged hand was 96%, which was significantly lower than the non-injured side's range of 85% to 100%. The functional outcome was satisfactory. Up to 18 patients (90%) patients reported being extremely satisfied, while 2 (10%) patients reported being satisfied. Conclusion: Bouquet pinning and transverse wiring techniques in metacarpal fractures showed good range of motion (total active motion >245), grip strength, early radiographic bone union and less post-operative infection. [ABSTRACT FROM AUTHOR]