Neck of the 5th metacarpal head retrograde screwing with a headless screw after a recurrent fracture on osteosynthesis pins: a case report

TL;DR

A soldier with a recurring hand fracture was successfully treated using a new screwing technique, allowing full recovery in six weeks.

Contribution

This is the first reported use of headless screw osteosynthesis for recurrent 5th metacarpal neck fractures.

Findings

The headless screw technique successfully treated a bent pin and recurrent fracture in a military patient.

The patient returned to unrestricted activities within six weeks post-surgery.

The method shows practical benefits for short-term functional recovery in similar cases.

Abstract

This paper reports the technique we used to treat a recurrent fracture of the neck of the 5th metacarpal with bending of the pin that was still present in the patient bone.

A 26-year-old soldier presents to the emergency department following a direct trauma on the right hand. This patient had already presented a similar trauma one year ago with a fracture of the 5th metacarpal neck treated by intramedullary pins according to Foucher technique's. X-rays showed a recurrent fracture of the 5th metacarpal neck with pins bended. It was decided to remove the material with a change of osteosynthesis technique by intramedullary screwing with a headless screw. This allowed a return to work and activities without restriction 6 weeks after surgery.

to our knowledge this is the first publication dealing with management of recurrent fracture of 5th metacarpal neck. This technique provides excellent outcome and a low risk of complication.

This simple and original technique for revision osteosynthesis of a fracture the 5th metacarpal neck gives good short-term results and is interesting from a practical and functional point of view in the military patients.

•We received in the E.D a soldier with an iterative fracture of the 5th metacarpe.•X-rays showed that his osteosynthesis pin was bended.•We performed a one-stage surgery with placement of a centro medullary screw to treat and prevent a new fracture.

We received in the E.D a soldier with an iterative fracture of the 5th metacarpe.

X-rays showed that his osteosynthesis pin was bended.

We performed a one-stage surgery with placement of a centro medullary screw to treat and prevent a new fracture.

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