Metacarpal shaft fractures of the fingers: treatment with interosseous loop wire fixation and immediate postoperative finger mobilisation in a wrist splint

It is widely believed that interosseous loop wire fixation of metacarpal shaft fractures alone is not rigid enough to allow immediate postoperative mobilisation. In this report, the author reviews the results in 36 cases of metacarpal shaft fractures of the fingers treated by interosseous loop wire fixation and immediate postoperative mobilisation of all finger joints. The study included 30 males and six females, with a mean age of 31 (range 12–52) years. The fracture pattern was transverse in 26 and oblique, or spiral, in the remaining 10 patients. Following loop wire fixation, the wrist was immobilised using a volar plaster splint for 3 weeks but all finger joints were mobilised immediately after surgery. After a mean follow-up of 8 weeks, all patients, except two, had regained full range of motion of the fingers and no complications were noted. It was concluded that interosseous loop wire fixation of metacarpal shaft fractures is rigid enough to allow immediate postoperative finger mobilisation in a wrist splint and achieve good functional results.