[The surgical treatment of fractures of the base of the fifth metacarpal bone].

Fractures of the base of the fifth metacarpal bone are relatively uncommon injuries. In contrast to similar fractures of the first metacarpal bone, various methods of treatment have been advocated. Some believe that cast immobilization or immediate unrestricted motion is a reliable method, while others recommend surgery and pinning or plate fixation. Fractures of the base of the fifth metacarpal bone are inherently unstable and inadequate reduction may result in pain, functional disability and osteoarthritic changes. We retrospectively reviewed 14 cases with intra-articular or extra-articular fractures of the base of the fifth metacarpal bone between the years 1991-1998. Patient treatment included closed reduction and percutaneous pinning using an image intensifier. Open reduction with multiple Kirschner pinning was implied in comminuted fractures and in cases when closed restoration of the articular surface was unfeasible. On follow-up examinations, all patients had good functional outcomes with no arthritic changes. We recommend reduction, restoration of the articular surface and pinning as the method of choice in the treatment of these fractures.