Percutaneous intramedullary fixation of metacarpal shaft fractures

Twenty-two displaced metacarpal shaft fractures in 19 patients were stabilized with multiple intramedullary K-wires. These were inserted percutaneously through a small window in the base of the metacarpal and were buried in the bone. No external splintage was routinely used postoperatively and all patients were encouraged to mobilize their fingers immediately: formal physiotherapy was not usually required. All the fractures that we were able to follow-up united, but the K-wires bent at the fracture site in two instances, producing 20° angular deformities. The buried K-wires had to be removed in one instance as a result of protrusion into the carpometacarpal joint.