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 fracture healing, and there were no malunions. One was re-done owing to inadequate reduction intra-operatively, 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 fractures 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.