• The treatment of fractures by inserting longitudinal intramedullary wires for fixation has been applied in 30 patients with metacarpal fractures. Local anesthesia was obtained for fractures of the fifth metacarpal (80 % of this series) by blocking the ulnar nerve, which is easily accessible at the elbow. Reduction is accomplished with direct pressure over the fracture toward the palm of the hand and counter pressure dorsally on the flexed proximal phalynx. The wire or pin is gently drilled longitudinally through the soft surface of the head and should run the full length of the bone so as to engage the proximal end and produce adequate fixation. In most cases bony union has been solid enough in three weeks to remove the wire. The patients have been able to return to work at once, and no infections or refractures have occurred.
Lord RE. INTRAMEDULLARY FIXATION OF METACARPAL FRACTURES. JAMA. 1957;164(16):1746–1749. doi:10.1001/jama.1957.02980160018005
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