Minimally Invasive Hybrid Fixation for Unstable Metacarpal Shaft Fractures: A New Approach to Extend Intramedullary...

Area of Science:

• Orthopedic surgery
• Hand surgery
• Trauma surgery

Background:

• Metacarpal shaft fractures, particularly long-oblique and spiral patterns, present challenges for traditional fixation methods.
• Isolated intramedullary screw fixation may be suboptimal for these unstable fracture types.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of a hybrid fixation technique for long-oblique and spiral metacarpal shaft fractures.
• This technique combines intramedullary screw fixation with minimally invasive suture cerclage.

Main Methods:

• Retrospective analysis of 27 patients with closed metacarpal shaft fractures treated with the hybrid technique.
• Assessment of functional outcomes (range of motion, grip strength, patient-reported scores) and radiological union via CT scan.
• Prospective recording of complications.

Main Results:

• All 27 patients achieved radiographic union within 3 months (mean 90.1% trabecular bridging on CT).
• Excellent functional recovery observed: mean total active motion 166°, 96.6% grip strength recovery.
• Low complication rate, with no implant failures or rotational deformities; one case of mild scar tenderness.

Conclusions:

• The hybrid fixation technique is safe and effective for unstable metacarpal shaft fractures.
• The technique provides axial and rotational stability, enabling early motion and high union rates.
• Supports expanding indications for intramedullary fixation to more complex fracture patterns.