Is Retrograde Pinning Reliable for Multiple Metatarsal Fractures?

Background: Fixation with K-wires is a commonly used method in the surgical treatment of metatarsal fractures. The application of K-wires can be antegrade and retrograde. There is a limited number of studies about the fixation of metatarsal fractures with retrograde K-wires in the literature. The present study aims to investigate the long-term results of retrograde pinning. Methods: 14 patients with at least a four-year follow-up were included in the study. The patients’ union status, demographic data, duration of surgery, duration of fluoroscopy use, metatarsophalangeal (MP) range of motion, American Orthopedic Foot and Ankle Score (AOFAS) scores, and plantar keratosis formation were evaluated. Results: Complete union was observed in 13 of 14 patients. MP joint restriction was not found in any patient with a union. Symptomatic plantar keratosis was not observed in any patient. Good and perfect results were obtained in AOFAS scores. Conclusion: According to the literature, retrograde pinning in metatarsal fractures is thought to be a treatment that is difficult to apply, has high radiation exposure, and complications are observed frequently. Contrary to previous beliefs about the difficulties and risks associated with retrograde pinning, our study found this method to be effective and associated with fewer complications in long-term follow-up.