Percutaneous transverse intermetacarpal pinning for displaced metacarpal fracture: a functional and radiological outcomes

Introduction
Metacarpal fractures represent 36% of hand and wrist fractures and may have a negative impact on hand function. Numerous surgical techniques have been outlined to manage these fractures, but there has been no consensus on the most suitable method or technique. This study aimed to assess the advantages of using the transverse intermetacarpal Kirschner wires fixation [percutaneous transverse intermetacarpal pinning (PTIP technique)] using the normal adjacent metacarpal bone as an internal-external fixator for the fractured one, also the functional and radiological outcomes and the postoperative complication rates.


Patients and methods
Between January 2023 and January 2024, 20 patients with 23 unstable ulnar and four metacarpal fractures undergoing PTIP were prospectively recruited. We investigated clinical and functional outcomes in terms of total active range of motion, grip strength, and quick disability arm shoulder hand score.


Results
The mean age was 36±10.32 years, and the time of healing (weeks) was 6.59±1.01. At the final follow-up, the total active of motion was 258.95±11.97, grip strength (%) compared with the normal side was 100.37±5.89, and quick disability arm shoulder hand score was 2.75±2.9.


Conclusion
The PTIP technique is an acceptable and effective method for managing acute, unstable metacarpal fractures with satisfactory results with low complication rate.