Abstract

Aim: The fifth metacarpal shaft is one of the most common fracture sites of the hand. Although most of these fractures treated conservatively, there is no consensus about the fixation method if surgical treatment is required. This study aims to compare intermetacarpal fixation (IF) and plate fixation (PF) in the treatment of fifth metacarpal shaft fractures.
Methods: A total of 59 patients treated with intermetacarpal fixation or plate fixation due to metacarpal shaft fractures of the small finger were included in this study. Clinical assessment included total active motion, grip strength, and Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) scores. Radiologically, angulation, rotation, and shortening of the little finger were measured via picture archiving and communication system of the hospital.
Results: The duration of the surgeries of the PF group was significantly higher than the IF group. Although the radiological shortening and the rotation of the finger were found higher in the IF group, the differences were not significant. The grip strength of IF patients were higher than PF patients (p=0.029).
Conclusion: This study demonstrated that intermetacarpal fixation of fifth metacarpal shaft fractures can provide similar stability as open reduction and plate fixation. Stable intermetacarpal fixation allows early rehabilitation as plate fixation.

Key words: Fifth metacarpal, Metacarpal shaft, Metacarpal fracture, Percutaneous fixation, Locked plate