Reduction of 5th Metacarpal neck Fractures using modified Pin Leverage technique

I n t r o d u c t i o n: Although the majority of metacarpal neck fractures could be treated conservatively with closed reduction and immobilization, some unstable or irreducible fractures are managed by surgery. Authors applied modified pin leverage reduction technique for unacceptably angulated and irreducible 5th metacarpal neck fractures. The aim of this study is to determine the efficacy of modified pin leverage technique in 5th metacarpal neck fractures. Material and Method: In this retrospective study, we reviewed 29 cases of 5th metacarpal neck fractures reduced by modified pin leverage technique between May 1998 and Feburary 2002. We analyzed the preoperative and postoperative angulation on the radiographs, operation time, bone union period, postoperative complications and range of motion. R e s u l t s: Average length of follow up period was 23 months with 27.5 years of mean age. Average length of interval period between injury and operation day was 5.2 days. Average posterior angulation was 51.3°in the preoperative lateral radiographs and 17.8°at the last follow up. Central pin was removed at postoperative 25 days and oblique pin was removed at 39 days on an average. There was one case of temporary superficial pin track infection and range of motion was satisfactory in all cases except one case of decreased metacarpophalangeal joint motion. Discussion and Conclusion: In operative treatment of 5th metacarpal neck fractures, modified pin leverage reduction technique is a good alternative method prior to open reduction in case of difficult closed reduction.