Flexible Stable Intramedullary Nailing for the Management of Metacarpal Neck Fractures

Introduction  When dealing with metacarpal neck fractures, the aim of treatment should include clinical and radiological objectives. The aim of this study was to assess the efficacy of flexible stable intramedullary nailing for the management of metacarpal neck fractures. Materials and Methods  A total of twenty four patients (22 males and 2 females; mean age: 28.2 ± 7.7 years) with metacarpal neck fractures (second in 7 patients and fifth in 17 patients) whether isolated or associated with other body injuries and managed by percutaneous flexible stable intramedullary nailing were reviewed for a retrospective case series. Personal interviews were conducted together with clinical and radiological assessments. The final results were recorded at the time of personal interviews. Results  The mean duration of surgery was 19.3 ± 2.5 minutes. The mean time of radiological union was 5 ± 1.3 weeks. The mean postoperative active range of motion of the metacarpophalangeal joint was 102.4 ± 11 degrees. The mean supination power of the involved hand in comparison to the contralateral side was 97.8 ± 3.4%, whereas the pronation power percentage was 99.2% ± 1.6. The mean power grip percentage to the contralateral side was 96.4 ± 2.9%, whereas the mean percentage of the pinch grip was 96.1 ± 4.2%. The mean postoperative DASH (Disability of Arm, Shoulder, and Hand) score was 0.3 ± 0.5. Conclusion  Percutaneous flexible stable intramedullary nailing for the treatment of metacarpal neck fractures has expanded the armamentarium of the orthopaedic surgeons as an easy, cost-effective technique overcoming all possible deformities and allowing early and reliable active rehabilitation. Level of Evidence  This is a Type IV, therapeutic retrospective case series.