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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...

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Related Experiment Video

Updated: Jun 16, 2026

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
15:11

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Published on: January 5, 2015

Plates or K-Wires Fixation for Fifth Metacarpal Neck Fractures? A Comparative Study.

Yener Yoğun1, Batu Malatyali2, Mehmet Batu Ertan3

  • 1Hand Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey.

The Journal of Hand Surgery Asian-Pacific Volume
|June 15, 2026
PubMed
Summary

Open reduction internal fixation (ORIF) is not superior to closed reduction percutaneous pinning (CRPP) for fifth metacarpal neck fractures. CRPP is recommended due to a lower complication rate compared to ORIF.

Keywords:
Fifth metacarpalK-wireMetacarpal neck fracturePlate fixationVolar angulation

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Hand Surgery

Background:

  • Metacarpal neck fractures are common, comprising about half of all hand fractures.
  • Optimal surgical management for fifth metacarpal neck fractures remains debated.
  • Open reduction internal fixation (ORIF) and closed reduction percutaneous pinning (CRPP) are common surgical options.

Purpose of the Study:

  • To compare clinical and radiological outcomes of ORIF versus CRPP for fifth metacarpal neck fractures.
  • To evaluate functional recovery, grip strength, and complication rates between the two surgical methods.
  • To determine the preferred surgical approach for fifth metacarpal neck fractures.

Main Methods:

  • Retrospective evaluation of 71 patients with fifth metacarpal neck fractures treated with ORIF (n=31) or CRPP (n=40).
  • Clinical outcomes assessed using Visual Analogue Scale (VAS) and Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) scores.
  • Radiological assessment of angulation and shortening, with grip strength measured using a Jamar dynamometer.

Main Results:

  • No significant differences in clinical or functional outcomes between ORIF and CRPP groups.
  • Similar postoperative grip strength, radiological results, and follow-up durations were observed.
  • The complication rate was significantly higher in the ORIF group compared to the CRPP (K-wire) group.

Conclusions:

  • ORIF is not superior to CRPP for surgical management of fifth metacarpal neck fractures.
  • CRPP is associated with a lower complication rate.
  • Open reduction plate screw fixation is not recommended as the primary treatment for these fractures.