Long oblique/spiral mid-shaft metacarpal fractures of the fingers: treatment with cerclage wire fixation and immediate post-operative finger mobilisation in a wrist splint

The cerclage wire technique of internal fixation for displaced long oblique/spiral metacarpal shaft fractures has not gained popularity for two reasons: many believe that wire migration is a real possibility and that the fixation technique is not rigid enough to allow immediate postoperative finger mobilisation. In this report, the authors review the results of 19 cases of long oblique/spiral mid-shaft metacarpal shaft fractures of the fingers treated by cerclage wires and immediate postoperative mobilisation of all finger joints. The study included 17 men and two women with a mean age of 35 (range 18–45) years. After a mean follow-up of 8 weeks, all patients regained full range of motion of the fingers and no complications were noted. It is concluded that cerclage wire fixation of long oblique/spiral mid-shaft metacarpal fractures requires neither scoring of the bone (a technique recommended by other authors to prevent wire migration) nor finger immobilisation and that the technique consistently achieves good functional results.