Metacarpal Neck Fractures Research Articles

Flexible Stable Intramedullary Nailing for the Management of Metacarpal Neck Fractures

Introduction When dealing with metacarpal neck fractures, the aim of treatment should include clinical and radiological objectives. The aim of this study was to assess the efficacy of flexible stable intramedullary nailing for the management of metacarpal neck fractures.Materials and Methods A total of twenty four patients (22 males and 2 females; mean age: 28.2 ± 7.7 years) with metacarpal neck fractures (second in 7 patients and fifth in 17 patients) whether isolated or associated with other body injuries and managed by percutaneous flexible stable intramedullary nailing were reviewed for a retrospective case series. Personal interviews were conducted together with clinical and radiological assessments. The final results were recorded at the time of personal interviews.Results The mean duration of surgery was 19.3 ± 2.5 minutes. The mean time of radiological union was 5 ± 1.3 weeks. The mean postoperative active range of motion of the metacarpophalangeal joint was 102.4 ± 11 degrees. The mean supination power of the involved hand in comparison to the contralateral side was 97.8 ± 3.4%, whereas the pronation power percentage was 99.2% ± 1.6. The mean power grip percentage to the contralateral side was 96.4 ± 2.9%, whereas the mean percentage of the pinch grip was 96.1 ± 4.2%. The mean postoperative DASH (Disability of Arm, Shoulder, and Hand) score was 0.3 ± 0.5.Conclusion Percutaneous flexible stable intramedullary nailing for the treatment of metacarpal neck fractures has expanded the armamentarium of the orthopaedic surgeons as an easy, cost-effective technique overcoming all possible deformities and allowing early and reliable active rehabilitation.Level of Evidence This is a Type IV, therapeutic retrospective case series.

Osteosynthesis of fifth metacarpal neck fractures with a photodynamic polymer bone stabilization system.

Metacarpal neck fractures with severe displacement are commonly treated surgically with intramedullary Kirschner wires. We present the results of treatment of fifth metacarpal neck fractures using a light curable intramedullary photodynamic polymer (IlluminOss™, IlluminOss Medical Inc., East Providence, RI, USA). Twenty-nine patients with isolated displaced fifth metacarpal neck fractures were included and followed up for 12-24 weeks. All fractures had radiologically healed after 3 months. In two cases, a secondary loss of reduction was seen, which did not require further correction. During the follow-up period, range of motion of the metacarpophalangeal joint was 89% after 6 weeks and increased to 100% after 3 months compared with the uninjured side. Grip strength improved over time from 61% to 85%. No implant removal was necessary. We conclude that osteosynthesis using an intramedullary photodynamic polymer is a reliable treatment option for displaced fractures of the fifth metacarpal neck. Level of evidence: IV.

Efficacy evaluation of closed reduction of fifth metacarpal neck fractures in children

This article covers the retrospective analysis of the results of treatment of 47 children aged 9 to 17 years with V metacarpal neck fractures, based on the data of radiation studies. The treatment of fifth metacarpal neck fractures, without reduction, does not have a reliable positive result. At large angles of deformity of the V neck of the metacarpal (>45°), the use of closed reduction leads to a significant positive therapeutic effect in the immediate observation period. However, from our point of view, the persistence of the displacement V metacarpal bone with sufficiently large degree in certain cases and the presence of posttraumatic changes in the structure of the heads, subcapital and growth zones in the observed patients cannot satisfy specialists from the standpoint of modern children’s traumatology. Thus, changes in the structure of the heads and subcapital zones in the long-term radiological control of the group were found in 11. 1% of patients who were treated without reduction with a stabilizing plaster cast and in 55% of patients who underwent closed reduction of the metacarpal fractures. The predominance of the narrowing of the growth zone of the injured V metacarpal bone occurs in patients who undergo a closed manual reduction, which may be due to the traumatic effect on the physical zone of the primary force or reduction manipulations. All this indicates the feasibility of further scientific research of this problem with the prospect of developing therapeutic technologies that allow to achieve a complete anatomical reposition of the metacarpal bones in pediatric patients.

Variation Amongst Orthopedic Surgeons When Treating Fifth Metacarpal Neck Fractures in the Pediatric Population

Introduction: Fifth metacarpal neck fractures are common fractures affecting the pediatric population. However, no true standardization exists regarding their treatment. The purpose of this study was to determine if variation exists amongst orthopedic surgeons in treating pediatric fifth metacarpal neck fractures and determine the factors regarding this variation. Materials and Methods: Twenty-five sets of images of pediatric fifth metacarpal …

Variation Amongst Orthopedic Surgeons When Treating Fifth Metacarpal Neck Fractures in the Pediatric Population

Variation Amongst Orthopedic Surgeons When Treating Fifth Metacarpal Neck Fractures in the Pediatric Population

Pediatric Hand Injuries Requiring Closed Reduction at a Tertiary Pediatric Care Center.

Background: Hand fractures and dislocations are common injuries in the pediatric population. This study aims to characterize the pediatric hand injuries that required closed reduction and identify those that required multiple reduction attempts. Methods: A retrospective cohort study was carried out in patients younger than 18 years of age with hand fractures or dislocations who underwent closed reduction in the emergency department (ED). Patients who ultimately required surgical reduction and fixation were not included. Results: Of the 310 hand injuries identified, 148 (114 fractures and 34 dislocations) underwent closed reduction in the ED; 7.4% of those required repeat reduction. Hand injuries that most often required repeat reduction included metacarpophalangeal joint dislocations (20.0%) and proximal phalanx neck (16.7%), metacarpal shaft (15.4%), metacarpal neck (6.2%), and proximal phalanx base (5.6%) fractures. No modifiable risk factors predicting the need for repeat reduction were identified. Conclusions: Some pediatric hand injuries are more likely to require repeat closed reduction by a hand surgeon. This retrospective study is the first step toward quality improvement as it provides opportunities for further research into the factors contributing to reductions that are unsuccessful at the first attempt. Identification of these factors and implementation of quality improvement measures are necessary to ensure the effective treatment of all pediatric hand injuries.

A Simple Technique to Improve the Accuracy of Plaster Molding in Metacarpal Neck Fractures

Metacarpal neck fractures are mostly reduced in A&E or in fracture clinic. Once the cast is applied a simple technique is described to locate the metacarpal head. On the uninjured hand, measurement is taken from the tip of corresponding finger to the metacarpal head. This measurement is transferred on to the cast for further reduction and moulding. This technique provides a reliable outcome.

Comparison of functional metacarpal splint and ulnar gutter splint in the treatment of fifth metacarpal neck fractures: a prospective comparative study

BackgroundFifth metacarpal fractures are the most common fractures of the hand. These fractures are generally treated with conservative methods. The aim of this study was to compare the radiological and clinical outcomes of two conservative treatment methods, functional metacarpal splint(FMS) and ulnar gutter splint(UGS), for the treatment of fifth metacarpal neck fractures.MethodsA prospective comparative study was designed to assess the conservative treatment of isolated and closed stable fractures of the fifth metacarpal neck. In total, 58 patients were included in the study and were treated with FMS or UGS after fracture reduction in a consecutive order. Angulation, shortening and functional outcome (QuickDASH scores and grip strengths) were evaluated at the 2nd and 6th months.ResultsForty patients returned for follow-up. Twenty-two patients were treated with FMS, and 18 patients were treated with UGS. The average age was 28 years (SD ± 12, range;18–43) in the FMS group and 30 years (SD ± 14, range;18–58) in the UGS group. After reduction, significant correction was achieved in both groups, but the average angulation was lower in the FMS group(16 ± 7) compared with the UGS group (21 ± 8)(p = 0.043). However, this better initial reduction in FMS group(16 ± 7) could not be maintained in the 1st month follow-up (21 ± 5) (p = 0.009). In the FMS group, the improvement in QuickDASH scores between the 2nd and 6th month follow-up was significant (p = 0.003) but not in the UGS group(p = 0.075). When the expected grip strengths were calculated, the FMS group reached the expected strength values at the 2nd month follow-up, whereas the UGS group still exhibited significantly lower grip strength at the 2nd month follow-up(p = 0.008). However, at the end of the 6th month follow-up, both groups exhibited similar reduction, QuickDASH and grip strength values.ConclusionsIn stable 5th metacarpal neck fractures, FMS is adequate to prevent loss of reduction and yields faster improvement in clinical scores with earlier gain of normal grip strength compared with UGS. However, in the long term, both FMS and UGS methods yield similar radiological and clinical outcomes. Patient comfort and compliance may be better with FMS due to less joint restriction, and these findings should be considered when deciding the treatment method.Trial registrationISRCTN79534571The date of registration: 01/04/2019Type of study/level of evidence: Therapeutic, II.

Intramedullary Screw Fixation of Metacarpal Fractures Results in Excellent Functional Outcomes: A Literature Review.

Intramedullary fixation of a comminuted subcapital metacarpal fracture using a headless compression screw was first described in 2010. The purpose of this study was to identify and evaluate all studies reporting clinical outcomes of intramedullary screw fixation of metacarpal fractures. A comprehensive search of the literature was performed under Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to identify all relevant studies. Outcome measures included mean follow-up, evidence of radiographic union, functional outcomes, and quality-of-life measures. Nine articles for a total of 169 metacarpal fractures were identified. Average patient age was 32 years; 86.5 percent of the patients were men; and the majority of fractures occurred in the small finger (74 percent). Most fractures occurred in the neck (n = 66), followed by shaft (n = 31) and head (n = 10). The average follow-up was 11 months, with an average metacarpophalangeal joint flexion of 86 degrees (n = 83) and digit total active motion of 251 degrees (n = 72). Radiographic union was achieved in 100% of reported cases (n = 132) at or before the latest follow-up. Grip strength in four studies showed an average of 96 percent compared to the contralateral hand. No serious complications were reported. Nine minor complications were reported, including four cases of hardware removal in asymptomatic patients. The review of the literature suggests intramedullary fixation of metacarpal neck and shaft fractures using headless compression screws has thus far proven to be a safe and successful surgical treatment option resulting in excellent clinical outcomes.

Low Rate of Complications Following Intramedullary Headless Compression Screw Fixation of Metacarpal Fractures.

Background: There has been a recent increase in the use of headless compression screws for fixation of metacarpal neck and shaft fractures as they offer several advantages, and minimal complications have been reported. This study aimed to evaluate the clinical complications and their solutions following retrograde intramedullary headless compression screw fixation of metacarpal fractures. We describe complications and the approach to their management. Methods: We performed a multicenter case series through retrospective review of all patients treated with intramedullary headless screw fixation of metacarpal fractures by 3 fellowship-trained hand surgeons. Patient demographics, implant used, type of complication, pre- and postoperative radiographs, operative reports, and sequelae were reviewed for each case. We defined complications as infection, loss of fixation, hardware failure, malrotation, nonunion, malunion, metal allergy, and any repeat surgical intervention. Results: Four complications (2.5%) were identified through the review of 160 total metacarpal fractures. One complication was a nickel allergy, one was a broken screw after repeat trauma, and 2 patients had bent intramedullary screws. Screw removal in 3 patients was simple and without complications or persistent limitations. One bent screw with a refracture was left in place. No serious complications were seen. Conclusion: Intramedullary screw fixation of metacarpal fractures is safe with a low incidence of complications (2.5%) that can be safely and effectively managed.

Clinical Outcomes of Limited Open Intramedullary Headless Screw Fixation of Metacarpal Fractures in 91 Consecutive Patients.

Background: The objective of the study is to evaluate clinical and radiographic outcomes in patients treated with limited-open retrograde intramedullary headless screw (IMHS) fixation for metacarpal neck and shaft fractures. Methods: Retrospective review of 91 consecutive patients (79 men; 12 women), mean age 28 (range =15-69) years, treated with IMHS fixation for acute displaced metacarpal neck (N = 56) and shaft (N = 35) fractures at a single institution. Mean follow-up was 10 (range = 1-71, median = 3) months. Preoperative mean magnitude of metacarpal neck angulation was 48° (range = 0°-90°), and mean shaft angulation was 42° (range = 0°-70°). Active motion was initiated within 5 days postoperatively. Clinical outcomes were assessed with digital goniometry, grip strength, and return to full activity. The time to radiographic union and radiographic arthrosis was assessed. Results: All 91 patients achieved full functional arc of metacarpophalangeal (MCP) motion, and all achieved full active MCP extension or hyperextension. At mean follow-up of 10 months, postoperative mean MCP joint flexion-extension arc was 88° (range = 55°-110°). Grip strength was available for 52 patients and measured 104.1% of the contralateral hand (range = 58%-230%). Radiographic union data were available for 86 patients. Seventy-six percent (65/86) achieved radiographic union by the end of week 6 (range = 2-10 weeks). Early arthrosis was noted in 1 patient at the MCP. There were 3 cases of shaft refracture after recurrent blunt trauma, following prior evidence of full osseous union. Conclusions: The IMHS fixation is safe, reliable, and durable for metacarpal neck/subcapital, axially stable shaft fractures, and select delayed unions or malunions. It allows for early postoperative motion without affecting union rates and obviates immobilization. This technique offers distinct advantages over formal open reduction and percutaneous Kirschner wire techniques.

Comparison study of three fixation methods for the treatment of the fifth metacarpal neck fractures

Objective To compare the clinical efficacy of closed reduction Kirschner wire transverse fixation, open reduction Kirschner wire cross fixation and open reduction plate screw fixation in the treatment of the fifth metacarpal neck fractures. Methods From March 2010 to January 2017, 83 patients with fresh closed fifth metacarpal neck fractures were treated by closed reduction Kirschner wire transverse fixation (34 cases as group A), open reduction Kirschner wire cross fixation (22 cases as group B) and open reduction plate screw fixation (27 cases as group C). According to the operation time, the number of C-arm fluoroscopy, complications, joint function recovery, grip strength and patient satisfaction, the efficacy of the three surgical methods was evaluated comprehensively. Results All the 83 patients were follow-up for 7 to 33 months with an average of 16.5 months. All the fractures achieved anatomical reduction and bone healing. At the last follow-up, there were no significant differences in grip strength, fracture healing time, complications and C-arm fluoroscopy frequency among the three groups (P>0.05). The operative time between group A and group B, group A and group C were significantly different (P 0.05). According to the upper extremity function evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association, the results were rated as excellent in 27 cases, good in 4 cases and fair in 3 cases with the excellent and good rate being 91.2% for group A; the results were rated as excellent in 15 cases, good in 5 cases and fair in 2 cases with the excellent and good rate being 90.9% for group B; the results were rated as excellent in 16 cases, good in 7 cases and fair in 4 cases with the excellent and good rate being 85.2% for group C. Conclusion The application of closed reduction Kirschner wire transverse fixation in the treatment of fresh closed fifth metacarpal neck fractures has the advantages of easy operation, short operation time, stable fixation, little joint and tendon irritation and allowing early functional exercise. It has satisfactory efficacy and is worthy of clinical promotion. Key words: Metacarpal bones; Fractures,bone; Comparative study; Kirschner wire; Plate

A single antegrade intramedullary k-wire for fifth metacarpal neck fractures.

Antegrade intramedullary nailing (AIMN) using 2k-wires seems to be superior to other modalities in treating displaced fractures of the fifth metacarpal neck (FFMN). Few reports demonstrated similar results retrospective with a single k-wire. The aim of the study is to describe our single k-wire technique and evaluate the related results. This is a retrospective study of a continuous series of patients treated with a single intramedullary k-wire for FFMN. It includes 30 patients who met the criteria for surgery: a dorsal angulation of more than 30°, malrotation, or both. The mean clinical follow-up period was 7 ± 14.9 months. The mean pre-operative angle was 50° ± 11.35° and the mean immediate post-operative angle was 4.86° ± 2.8°. The mean immediate correction was 47° ± 9.3°. The mean correction at last follow-up was 45.14° ± 8.55°. Healing was obtained in all patients and bone union was achieved at a mean of 5.6 ± 1.2 weeks. The mean operative time was 8.5min. The mean C-arm usage (number of clicks) was 7.2 times. The mean exposure radiation time was calculated at 3.6s. The mean radiation dose was 0.08mGy/mm2. The mean satisfaction score was 1.26 ± 0.45. Quick-DASH and EQ-5D scores yielded excellent values. With potential benefits like lesser surgical time, radiation and cost, the use of a single AIMN could be safer, quicker and cheaper while reproducing similar clinical, functional and radiological outcomes to those reported with the use of 2k-wires.

Simple percutaneous pinning for management of unstable fifth metacarpal neck fractures

Background The purpose of this prospective study was to evaluate the clinical and radiographic outcomes of our new surgical technique, percutaneous antegrade intramedullary pinning, for the management of unstable displaced fifth metacarpal neck fractures. Patients and methods Between 2010 and 2014, 40 patients who met the inclusion criteria were invited for clinical and radiological follow-up. There were 38 males and two females. The mean age was 28 years. Clinical assessments included active range of motion of the injured fifth metacarpophalangeal (MP) joint; visual analog scale score for pain; grip strength; and disabilities of the arm, shoulder, and hand score. Radiological evaluation included angulation and shortening of the fifth metacarpal. Results The average follow-up duration was 18 months. Regarding clinical outcomes, the mean active range of motions of the fifth MP joints were 87°, the median visual analog scale scores were 0, the mean grip strengths were 95%, the mean disabilities of the arm, shoulder, and hand scores were 3, and mean period for return to work was 6 weeks. Regarding radiological outcomes, all fractures healed at a mean of 5.85 weeks, the mean residual angulation was 4°, and the mean postoperative shortening was 0.5 mm. Conclusion This technique is straightforward, and there is no incisional scar. The wires do not violate the MP joint that makes early joint motion possible. The operative time is relatively short compared with previous techniques. All patients in the study group had satisfactory clinical and radiographic outcomes. Level of evidence: therapeutic level IV, case series.

Reducing Healthcare Costs in the Management of Pediatric Metacarpal Neck Fractures.

Background:We hypothesize that a quality improvement initiative utilizing a Velcro ulnar gutter brace over traditional casting will impart significant savings without compromising clinical outcomes in the management of small metacarpal neck fractures.Methods:Baseline data on number and treatment regimens of small metacarpal neck fractures were collected starting in October 2015. Velcro ulnar gutter braces were purchased for all orthopedic clinics in December 2016. Patients with <70 degrees of angulation and no rotational deformity of the small finger were eligible to have brace treatment without reduction of the fracture. Data were collected each month on several patients managed by Velcro ulnar gutter brace.Results:Three hundred twelve pediatric patients met nonoperative guidelines. Before the intervention, patients were casted and followed radiographically for a minimum of 2 orthopedic clinic visits—which total $916.25 in charges. From October 2015 to November 2016, we treated <1% (1/147) of patients with metacarpal neck fractures without casting. Following the implementation of interventions from December 2016 to January 2019, the percentage of patients treated without cast immobilization increased to 54.5% (90/165), with a process mean shift to >65%. These patients did not have a scheduled follow-up or further radiographic evaluation. In the first 26 months of implementation, this decreased healthcare expenditures by $261,846.Conclusions:A quality improvement initiative emphasizing Velcro ulnar gutter brace treatment for pediatric metacarpal neck fractures resulted in a shift away from cast immobilization in >65% of patients, reducing risks and expenses of cast immobilization.

The ulnar four carpometacarpal joints dislocation and fracture associated with the metacarpal neck fracture: A case report

The ulnar four carpometacarpal joints dislocation and fracture associated with the metacarpal neck fracture: A case report

Comparison of the clinical efficacy of close reduction internal fixation with intramedullary pin and cross Kirschner wires for the treatment of metacarpal neck fractures

Objective To compare the clinical efficacy of close reduction internal fixation with intramedullary pin and cross Kirschner wires in the treatment of metacarpal neck fractures. Methods From March 2013 to March 2016, 85 cases of metacarpal neck fractures were treated in our hospital. Close reduction internal fixation with intramedullary pin was conducted in 49 cases (intramedullary pin group) and with cross Kirschner wires in 36 cases (Kirschner wire group). Both groups were performed by the same surgeon. After the operation the same functional exercise instruction was given. The hand function was evaluated by the TAFS system issued by American Hand Surgery Association 10 months after the operation. Results All the patients were follow-up for 10 to 16 months with an average of 12 months. The fracture healing time was 10 weeks in one case from each of the two groups, and 6 to 8 weeks in the other 83 cases. The average healing time was (6. 2 +2. 4) weeks from the intramedullary pin group and (6. 3 +1. 9) weeks from the Kirschner wire group. There was no significant difference in the healing time between the two groups (P>0. 05). TAFS scores of hand function were excellent in 39 cases, good in 7 cases, fair in 3 cases with the excellent and good rate being 93. 9% from the intramedullary pin group; while they were excellent in 16 cases, good in 14 cases, fair in 6 cases with the excellent and good rate being 83. 3% from the Kirschner wire group 10 months after the operation. The results from the intramedullary pin group were better than those from the Kirschner wire group. The difference was statistically significant (P<0. 05). Conclusion The close reduction internal fixation with intramedullary pin for the treatment of metacarpal neck fractures is a simple method with small trauma. It has little effect on hand function exercise after the operation. The score of hand function recovery is better than that of Kirschner wire group. Key words: Metacarpal bones; Fractures,bone; Fracture fixation, internal; Intramedullary pin; Cross Kirschner wires

Bouquet technique in the treatment of metacarpal fractures

Objectives The aim of this study was to evaluate the results of bouquet technique in fixation of metacarpal subcapital, neck, or shaft fractures regarding fixation stability and functional and radiological outcomes. Background Metacarpal subcapital, neck, or shaft fractures can be managed conservatively or operatively depending on fracture pattern and stability. Patients and methods A follow-up study in Boulak Eldakror Allgemein Hospital from July 2014 to February 2016 was conducted. Thirty cases of unstable metacarpal fractures were managed by antegrade intramedullary K-wires fixation and were documented and evaluated radiographically and functionally with follow-up for 6 months. Result Thirty cases were enrolled in this study. Fracture union was achieved in all cases at the mean of 5 weeks. At the last visit (6 months postoperatively), the total active motion score for 30 patients ranged from 170° to 260°, with mean of 222°. Normal score of 260°, with good functional and completely powerful hand, was recorded in three patients. The range of grip strength was 60–100%, with the mean of 86% compared with the healthy side. The range for Quick-DASH scores for 30 patients was from 15.9 to 0.0. Score 0 with sound union was recorded in 12 patients. Conclusion Antegrade intramedullary K-wires fixation in this study showed good functional and radiographic results with fewer complications.

Research progress in surgical procedures for fifth metacarpal neck facture

Clench beating or other direct violent action often leads to neck fracture combined with typical dorsal angulation deformity because of the special anatomical structure of the fifth metacarpal neck. There are various treatment methods for the fifth metacarpal neck fracture with their own advantages and disadvantages. Conservative treatment can achieve good fracture healing and has slight effect on function, yet often leaving appearance deformity. Kirschner wire fixations are varied and can obtain satisfactory results, but the drawbacks include obvious tendon adhesion and pin track infection. Microplate screw fixation can obtain good stability that allows early functional exercise. However, its disadvantages include scars, multiple surgeries, and higher medical expenses. External fixation has good curative effect on comminuted joint fracture. With the development of bioengineering technology, absorbable internal fixation is gradually applied to clinical treatment with satisfactory therapeutic effect, but its application is still limited due to the huge cost. Therefore, there is still no unified optimal therapeutic regimen. The author reviews the anatomical characteristics, fracture characteristics, treatment principles, and treatment methods so as to provide reference for formulation of clinical therapy. Key words: Metacarpal bones; Fractures, bone; Hand injuries

New fixation approach for transverse metacarpal neck fracture: a biomechanical study

BackgroundFifth metacarpal neck fracture, also known as boxer’s fracture, is the most common metacarpal fracture. Percutaneous Kirschner-wire (K-wire) pinning has been shown to produce favorable clinical results. However, the fixation power of K-wires is a major concern. Plate fixation is also a surgical option, but it has the disadvantages of tendon adhesion, requirement of secondary surgery for removal of the implant, and postoperative joint stiffness. A fixation method that causes little soft tissue damage and provides high biomechanical stability is required for patients with fifth metacarpal neck fracture for whom surgical intervention is indicated. The present study proposed fixation using K-wires and a cerclage wire to treat fifth metacarpal neck fracture. The fixation power of this new method was compared with that of K-wires alone and plates.MethodsWe used a saw blade to create transverse metacarpal neck fractures in 16 artificial metacarpal bone specimens, which were then treated with four types of fixation as follows: (1) locking plate with five locking bicortical screws (LP group), (2) regular plate with five bicortical screws (RP group), (3) two K-wires (K group), and (4) two K-wires and a figure-of-eight cerclage wire (KW group). The specimens were tested by using cantilever bending testing on a material testing system. The stiffness of the four fixation types was determined by observing force–displacement curves. Finally, the Kruskal–Wallis test was adopted to process the data, and the Mann–Whitney exact test was performed to conduct paired comparison between the fixation types.ResultsThe fixation strength levels of the four fixation approaches for treating fifth metacarpal neck fracture were ranked in a descending order of LP group (24.6 ± 5.1 N/mm, median ± interquartile range) > RP group (22.2 ± 5.8 N/mm) ≅ KW group (20.1 ± 3.2 N/mm) > K group (16.9 ± 3.0 N/mm).ConclusionThe fixation strength of two K-wires was significantly higher when reinforcement was provided using a figure-of-eight cerclage wire. The strength of the proposed approach is similar to that of a regular plate with five bicortical screws but weaker than that of a locking plate with the same amount of bicortical screws. Cerclage wire-integrated K-wires can be an alternative method that avoids the excessive soft tissue dissection required for plating in open reduction internal fixation for fifth metacarpal neck fracture.