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.