Clinical outcomes of retrograde percutaneous pinning for shaft fracture of metacarpal bone: A case series

Abstract Background Surgical treatment should be considered for metacarpal fractures that have severe angulation or shortening. Percutaneous pinning is a useful technique in that it is minimally invasive. Insertion of Kirschner wires using retrograde pinning is easier than that using antegrade or transverse pinning. The purpose of this study is to evaluate the functional outcomes of retrograde pinning. Methods Thirteen patients (15 fingers) were enrolled in this prospective study. All patients were treated using percutaneous retrograde pinning following a brachial plexus block. Two intramedullary Kirschner wires were inserted from the metacarpal head to its base. Clinical outcomes included range of motion (ROM), postoperative complications, and evaluation using the Quick Disabilities of the Arm, Shoulder, and Hand score at final follow up. Results ROM in extension/flexion for each joint at final follow up was: metacarpal phalangeal (MP) joint 3.1°/87.1°; proximal interphalangeal (PIP) joint 2.0°/103.3°; and distal interphalangeal (DIP) joint 0°/74.1°. The percent total active ROM was 91.9% and the Quick-DASH score was 2.7 out of 100. Pin tract infections occurred in two fingers and were treated with oral antibiotics. Conclusions In this study, retrograde Kirschner wire fixation was an acceptable technique for the treatment of displaced metacarpal fractures. This simple technique can correct deformity and provide good clinical outcomes.