Elastic retrograde intramedullary percutaneous pinning for fifth metacarpal neck fractures: A series of 32 patients

The aim of our study was to evaluate an original surgical technique for the treatment of fifth metacarpal neck fractures: elastic retrograde intramedullary percutaneous pinning (ERIPP). From January 2014 to January 2016, patients with a fifth metacarpal neck fracture with greater than 30 degrees volar displacement and/or clinodactyly were included. All patients underwent an ERIPP procedure. With this technique, K-wires are used as joysticks to assist reduction when the Jahss maneuver is insufficient. Clinical evaluation incorporated the DASH score, range of motion and grip strength at 3 months. Radiographic evaluation comprised apex dorsal angulation and metacarpal shortening at 1 month and 3 months. Thirty-two patients were included in the study. All fractures were healed after a mean of 5 weeks (range 4-7). The DASH score was less than 30 for all patients, indicating an absence of disability. There were no differences in grip strength at 3 months between the injured and the contralateral hand. There was less than 10 degrees extension deficit in the metacarpophalangeal joint. In our experience, retrograde percutaneous pinning is a stable, compressive fixation method with effective reduction of displaced fifth metacarpal neck fractures. However, this result needs to be confirmed in comparative studies. (C) 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.