Kickstand Technique for Intraoperative Reduction of Fifth Metacarpal Neck Fractures

      This article reports a novel intraoperative technique for the reduction of angulated metacarpal neck fractures undergoing retrograde headless intramedullary screw fixation. This technique is a useful reduction maneuver, especially for hand surgeons operating without a first assistant, because it eliminates the need to hold manual reduction during implant placement.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Van Onselen E.B.
        • Karim R.B.
        • Hage J.J.
        • Ritt M.J.
        Prevalence and distribution of hand fractures.
        J Hand Surg Br. 2008; 28: 491-495
        • Birndorf M.S.
        • Daley R.
        • Greenwald D.P.
        Metacarpal fracture angulation decreases flexor mechanical efficiency in human hands.
        Plast Reconstr Surg. 1997; 99: 1079-1083
        • Freeland A.E.
        • Geissler W.B.
        • Weiss A.P.
        Operative treatment of common displaced and unstable fractures of the hand.
        J Bone Joint Surg Am. 2001; 83: 928-945
        • Galal S.
        • Safwat W.
        Transverse pinning versus intramedullary pinning in fifth metacarpal's neck fractures: a randomized controlled study with patient-reported outcome.
        J Clin Orthop Trauma. 2017; 8: 339-343
        • Haddad E.
        • Zemour M.
        • Belkacemia Y.
        • Salem H.A.
        • Dohin B.
        L-pinning for fifth metacarpal neck fracture in adolescents.
        Orthop Traumatol Surg Res. 2022; 108102992
        • Wong K.P.
        • Hay R.A.
        • Tay S.C.
        Surgical outcomes of fifth metacarpal neck fractures—a comparative analysis of dorsal plating versus tension band wiring.
        Hand Surg. 2015; 20: 99-105
        • Zemirline A.
        • Vaiss L.
        • Lebailly F.
        • Gouzou S.
        • Liverneaux P.A.
        • Facca S.
        The MetaHUS(®) fixation system versus pinning and plating in 5th metacarpal neck fractures.
        Chir Main. 2014; 33: 207-210
        • Doarn M.C.
        • Nydick J.A.
        • Williams B.D.
        • Garcia M.J.
        Retrograde headless intramedullary screw fixation for displaced fifth metacarpal neck and shaft fractures: short term results.
        Hand (NY). 2015; 10: 314-318
        • Ruchelsman D.E.
        • Puri S.
        • Feinberg-Zadek N.
        • Leibman M.I.
        • Belsky M.R.
        Clinical outcomes of limited-open retrograde intramedullary headless screw fixation of metacarpal fractures.
        J Hand Surg Am. 2014; 39: 2390-2395
        • Jann D.
        • Calcagni M.
        • Giovanoli P.
        • Giesen T.
        Retrograde fixation of metacarpal fractures with intramedullary cannulated headless compression screws.
        Hand Surg Rehabil. 2018; 37: 99-103
        • ten Berg P.W.
        • Mudgal C.S.
        • Leibman M.I.
        • Belsky M.R.
        • Ruchelsman D.E.
        Quantitative 3-dimensional CT analyses of intramedullary headless screw fixation for metacarpal neck fractures.
        J Hand Surg Am. 2013; 38: 322-330
        • Stahl S.
        • Schwartz O.
        Complications of K-wire fixation of fractures and dislocations in the hand and wrist.
        Arch Orthop Trauma Surg. 2001; 121: 527-530
        • Fusetti C.
        • Meyer H.
        • Borisch N.
        • Stern R.
        • Della Santa D.
        • Paploizos M.
        Complications of plate fixation in metacarpal fractures.
        J Trauma. 2002; 52: 535-539