The application of Joshi clamp forms a scaffold so solid to permit immediate mobilization (Fig. The K-wires are successively bent to 90° and with a further bending they are joined using the Joshi clamp (Movie 2 and Figg. It is inserted while keeping the MP joints flexed by Jahss maneuver (Movie 1). It maintains metacarpal length and avoids rotational defects. in lag screw fixation of second to fifth metacarpals, esp w/ spiral fractures. injury to the small finger or 5th metacarpal commonly known as a boxers fracture. 5 and 10) is transversally inserted, with drill, distally to the fracture, bridging the fractured metacarpal neck or head to the nearest one. Complications of smooth pin fixation of fractures and dislocations in the. A metacarpal fracture is a fracture of one of the bones in the hand. If doubts, it is indicated to make a small incision to verify the situation. 8): finger’s extensor tendons sliding has to be checked before completing pin retrieving (Fig. Care has to be taken at the retrograde pin proximal exit point (Fig. The first pin is inserted longitudinally to restore the metacarpal length and to correct fracture angulation (it is inserted anterograde for 2 and 5 metacarpals and retrograde for 3 and 4 metacarpals ) its tip is gently curved (20°) to easily correct its direction during insertion (Fig. 2) or wide awake under fluoroscopic control (Fig. the treatment of these fractures, such as transverse k-wires pinning 9,10. Surgery is performed under loco-regional anaesthesia (Fig. Fifth metacarpal neck fractures are the most commonly injured metacarpal. The surgical instruments are very simple (Fig. Indications for surgery included displaced metacarpal fractures, with dorsal angulation deformity (according to Mayo clinic criteria, Fig.
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