Metacarpal Malunion Correction With Crescentic Osteotomy

Fractures of the metacarpals account for 18% to 44% of all hand fractures, with malunion being the most common complication. Sagittal plane malunion may result in extensor lag, bone shortening, loss of knuckle contour, and prominent dorsal or palmar bony deformity. In this paper, we describe a novel crescentic osteotomy technique of the border metacarpals stabilized with intramedullary screw fixation for the correction of extra-articular malunions. We report 3 cases of border metacarpal malunion treated with this method. At a median follow-up of 9 months (mean: 12.3 mo), patients achieved excellent outcomes, with a mean QuickDASH score of 1.5. This technique provides a safe, effective, and reproducible option for the correction of metacarpal malunions.