Single retrograde intramedullary wire fixation of metacarpal shaft fractures

From 1993 to present day, 110 metacarpal fractures
in 89 patients were stabilised using a method of
inserting a percutaneous intramedullary wire. This
allowed for early unimpeded movement in wrist and
hand together with ease of wire removal in clinic.
Reduction was maintained in all patients until frac-
ture healing, and there were no malunions. One was
re-done owing to inadequate reduction intra-opera-
tively, which thereafter united. One re-fractured and
was subsequently treated non-operatively. There
were two superficial infections. One patient was lost
to follow-up at 4 weeks ; the rest regained a full
range of pain-free movement. In a final assessment of
62 patients, the mean DASH score was 4.6.
We recommend this technique for metacarpal frac-
tures that are : transverse and off-ended ; angulated
transverse or short oblique ; multiple transverse or
short oblique. We do not recommend this technique
for long oblique or rotationally malaligned fractures.