الفهرس 
RELEVANT ANATOMYOnly 14 pages are availabe for public view
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Abstract
The 5th metacarpal fractures accounts for 40% of all hand fractures. Neck fractures are the commonest, as it is the weakest point in metacarpals, and accounts for about 10% of all hand fractures.
Although such fractures can be managed non-operatively; cases with palmar angulation of >30° and shortening of >5 mm would greatly affect hand function so surgical fixation is advocated for such fractures to prevent mal-rotation of the little finger which will lead to fingers overlap in a clenched fist.
Various techniques have been applied for the operative treatment of metacarpal fractures as antegrade intramedullary nailing (AIMN), retrograde intramedullary pinning by using Kirschner wire (K-wire), transverse pinning with K-wire, external fixation, and standard or low-profile plates.
It is important to ensure early and near immediate postoperative hand movement to improve the functional outcome and avoid joint stiffness which may occur even if there are no intra-articular fractures due to delay in starting active motion. As different techniques were described, the need to decide the ideal treatment method is crucial.
Finally we could conclude that, both techniques of treatment of 5th metacarpal neck fracture are valuable, easy and simple with minimal complications and excellent results.
CONCLUSION
Despite the limitations of the literatures included in our review, we found some evidence that the IM technique could have advantages over the use of transverse pinning in the treatment for the fifth metacarpal neck fractures. The quantitative analyses indicated probable better efficacy of IM particularly in relation to VAS, TAM, active ROM of the fifth ray and residual angulation. Our results can fit into the context of current practice where many hand surgeons consider the IM technique as their preferred method to treat neck fractures of the fifth metacarpal.
RECOMMENDATIONS
Further studies on large geographical scale and on larger sample size to emphasize our conclusion.
Larger randomized trials are needed to validate our results and to look for all other outcomes.
The implications for research are double; there is a need for a standardization of the outcomes related to this specific type of fracture, and peer review journals should systematically request from authors the provision of SD values whenever continuous data are reported in their trials.