Safe Percutaneous Pinning for Subcapital Fifth Metacarpal Fractures: an Anatomical Study

!"#$%&'#()*+,#-*%.#/%0-1*$23(#4*5./$%6.#(*35*%,#*-#$7*35*%,#* little finger metacarpal (boxer fractures) with percutaneous transverse K-wire fixation and other procedures, there may be iatrogenic injury to the dorsal digital branch to the little finger (DDBLF) of the dorsal branch of the ulnar nerve (DBUN). In this study we aimed to describe the relationship of the DDBLF of the DBUN and the insertion points on the external side of the fifth metacarpal during percutaneous transverse K-wire fixation of subcapital fractures. Methods: Dissections and measurements regarding this branch were performed after percutaneous transverse pinning to distal part of fifth metacarpal bones in ten cadaver hands formalin fixed. Results: The results of this study confirm the close proximity of the trajectory of the with this branch and demonstrate its potential iatrogenic injury during K-wire fixation of the fifth metacarpal. Conclusions: To avoid penetration of this nerve and limit the chances of iatrogenic injury it is important to know its course. The authors describe the anatomical insertion points and believe that using the anatomical knowledge, subcapital fifth metacarpal fractures can be treated without risk of sensory deficits.