Abstract
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.
Keywords
flexible nailing - metacarpal neck fractures - percutaneous - three-point fixation
