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