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Journals / Sakarya Tıp Dergisi / 2026 / Volume: 16 Issue: 1

Antegrade Intramedullary K-Wire or Retrograde Cross-Pinning? A Prospective Midterm Comparison

Koksal Gundogdu(DENİZLİ STATE HOSPITAL)0000-0001-6820-5625
Özcan Alaca(DENİZLİ STATE HOSPITAL)0009-0000-5364-3657
Ahmet Soyuçok(DENİZLİ STATE HOSPITAL)0000-0001-6327-7128
Alper Kurtoğlu(SAKARYA UNIVERSITY TRAINING AND RESEARCH HOSPITAL)0000-0001-9890-1330
Pages
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Publication Date
2026-03-28
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Exploratory findings indicated an earlier return to work and less work disability in the antegrade group.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: This study aimed to compare the mid-term clinical and radiological results of antegrade intramedullary (IM) K-wire fixation and retrograde cross-pinning techniques in unstable fifth metacarpal neck fractures.
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Key Findings & Data:Methods: In this study (January 2024–January 2025), 44 patients with preoperative neck angulation >30° underwent closed reduction followed by antegrade IM K-wire (n=16) or retrograde cross-pinning (n=28).
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Conclusion & Impact:Exploratory findings indicated an earlier return to work and less work disability in the antegrade group.
🔬Design:Survey & Empirical Study
📍Scope:2024 Verileri
⚙️Variables:Antegrade K-wire · Fifth metacarpal neck fracture · Retrograde cross-pinning

Abstract

Objective: This study aimed to compare the mid-term clinical and radiological results of antegrade intramedullary (IM) K-wire fixation and retrograde cross-pinning techniques in unstable fifth metacarpal neck fractures. Methods: In this study (January 2024–January 2025), 44 patients with preoperative neck angulation >30° underwent closed reduction followed by antegrade IM K-wire (n=16) or retrograde cross-pinning (n=28). Radiographs were assessed for metacarpal neck angle and residual shortening. Clinical outcomes— range of motion (ROM); metacarpophalangeal (MCP)/proximal interphalangeal (PIP)/distal interphalangeal (DIP) and total ROM), pain (visual analog scale (VAS)), DASH, and Brief Michigan Hand Questionnaire (bMHQ) —were recorded at 4 weeks, 3, and 6 months by assessors blinded to technique. Results: Baseline characteristics were comparable. Postoperatively, the antegrade approach was associated with a lower neck angle and less residual shortening ( p <0.05). At 4 weeks, the antegrade group was superior in MCP, PIP, and total ROM, while DIP was similar. At 3 months, the MCP/PIP benefit continued, but DIP and total ROM showed no difference. By 6 months, ROM differences were not significant. DASH and VAS were lower at 4 weeks and 3 months, and bMHQ was higher at 4 weeks; no between-group differences remained at 6 months. Exploratory findings indicated an earlier return to work and less work disability in the antegrade group. Conclusion: Antegrade IM K-wire fixation leads to earlier functional recovery, less pain, and better early alignment (less residual shortening), while outcomes are similar by 6 months. Technique choice should be tailored based on early recovery goals, soft-tissue considerations, and patient priorities.

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Cite This Article

Gundogdu, K., Alaca, Ö., Soyuçok, A., Kurtoğlu, A. (2026). Antegrade Intramedullary K-Wire or Retrograde Cross-Pinning? A Prospective Midterm Comparison. Sakarya Tıp Dergisi, Volume: 16 Issue: 1. https://doi.org/10.31832/smj.1793988

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