Transverse Pinning Versus Antegrade Intramedullary Pinning for Neck and Shaft Metatarsal Fractures

Condition(s) studied

Investigational drug(s) / intervention(s)

Transverse Pinning for neck and shaft Metatarsal Fractures: ⦁ Transverse Pinning Under spinal anaesthesia, the patient will be placed in the supine position. Under the guidance of an image intensifier, gentle longitudinal traction will be applied and percutaneous manipulation will be done using k wires and digital pressure.

Antegrade Intramedullary Pinning for neck and shaft Metatarsal Fractures: Antegrade Intramedullary Pinning Under spinal anesthesia, the patient will be placed in the supine position. Under guidance of an image intensifier, a small incision will be made over the dorsal aspect of the foot at the proximal end of the fractured metatarsal. Soft tissue will be dissected, taking care not to injure neurovascular structures and extensor tendons. An entry hole will be then made with a 2.0-mm drill bit. A 1.6-mm K-wire will be prepared with distal end bent through 5 and the prepared K-wire will be held by T-handle. The K-wire will be inserted through the entry hole and will be advanced to the medullary canal

Study summary

The aim of this prospective randomized controlled clinical trial study is to compare clinical, functional and radiological results of transverse pinning and antegrade intramedullary pinning for neck and shaft metatarsal fractures

Eligibility

Primary outcome measure(s)

• ⦁ Time to bone union — 12 weeks
  Immediate motion of the MTP joint and partial weightbearing in a stiff-soled shoe will be allowed. full weightbearing will be permitted 4 weeks after the operation. K-wires will be removed when pain subsided, which will be usually at 6 to 8 weeks for metatarsal head or neck fractures. For metatarsal shaft fractures, K-wires will be removed 3 months after the operation. union will be confirmed in radiographs taken at 12 weeks. Union will be confirmed by the presence of bridging trabeculae across the fracture site and resolution of fracture lines.

Trial sites (1)

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