Intramedullary Fixation for Epibasilar Thumb Metacarpal Fractures: A Case Series

Intramedullary (IM) fixation has gained popularity in the fixation of hand and finger fractures, given the ability to start early postoperative range of motion and relatively minimally invasive insertion. This article describes the surgical technique and clinical outcomes of intramedullary nail fixation for epibasilar thumb metacarpal fractures. Four patients with epibasilar thumb metacarpal fractures were treated with intramedullary nailing by 2 surgeons. Patients were evaluated for postoperative range of motion, Kapandji score, return to work, and functional outcomes. All patients were able to make a full fist by 2 weeks postoperatively and achieved full thumb opposition by 6 weeks postoperatively. All patients returned to work by 6 weeks postoperatively. This case series highlights intramedullary nailing as a promising approach to treat epibasilar thumb metacarpal fractures.