FLEXIBLE INTRAMEDULLARY NAILING FOR METACARPAL FRACTURES

A 5-year retrospective review of 83 patients with 98 metacarpal fractu res was performed. Fractures of the thumb metacarpal were excluded. Ni nety-six closed metacarpal fractures were reduced closed and fixed wit h flexible intramedullary fixation, using multiple 0.8-mm prebent rods . Two open metacarpal fractures were also fixed with this technique. F ractures amenable to flexible intramedullary fixation include short ob lique and transverse fractures. Contraindications include long oblique and bicortical comminuted fractures. The average follow-up lime was 9 months (range, 2 to 34 months) with 15 patients lost to follow-up exa mination. All fractures went on to heal. Three complications occurred: backing out of a rod in one case and bending of the rods after repeat trauma in two. There were no infections. Flexible intramedullary nail ing of specific metacarpal fractures affords excellent results with a low complication rate. Proper selection of fractures and good surgical technique are necessary to avoid complications.