Intra-medullary, at fracture site introduction of K-wires for metacarpal fracture fixation (in-site technique). A new fixation technique and a case series

PURPOSE: Metacarpal bone fractures represent one-fifth of upper extremity fractures. The most commonly affected bone was the fifth metacarpal also known as boxer’s fracture with a range 9.7–50%. Different techniques have been described for fracture fixation with K-wires being the most described technique. In this paper, we present a new technique utilizing k-wires to reduce and fix metacarpal fractures in an easy less traumatic way aiming to optimize the clinical outcomes in regards of range of motion and stiffness. METHODOLOGY: Retrospective chart review including all the patients that were managed with the new technique. RESULTS: 24 fractures were fixed with the new technique without violating the MCP joint with different fingers involvement and different presenting deformity. At the end of the splinting time, 80% of the cases had full ROM at the time of splint removal. The remaining 20% had some stiffness that improved with further physiotherapy. CONCLUSION: This approach is easy to teach, fast with good clinical outcomes. However, a larger sample size study comparing this technique to the existing treatment options is needed. TYPE OF STUDY: Case Series and literature review, Level IV.