Corrective Metacarpal Osteotomy With Intramedullary Screw Fixation: Technique and Case Report

Metacarpal malunion with significant angulation leading to symptoms from bony prominence in the palm or dorsum and decreased grip strength occur rarely, but may lead to patients requiring surgical correction. Corrective osteotomy procedures with plate fixation are commonly performed for these patients. Localizing the correct site of osteotomy and the required amount of bone removal for precise correction is difficult even with adequate preoperative planning. After osteotomy, plate osteosynthesis is the most common fixation method to allow for early mobilization; however, plate osteosynthesis can lead to soft tissue irritation, which may necessitate secondary surgeries for tenolysis and implant removal. This case study highlights our use of an intramedullary wire as an additional guide to the ideal site of osteotomy and then the use of an intramedullary screw for stabilization of the osteotomy site.