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Background: Most of the displaced metacarpal neck fractures are well corrected by a traditional reduction method, exerting the dorsally directed force through the MP joint at a right angle. However, it is sometimes irreducible. We demonstrate here a new reduction technique to correct typical apex dorsal angulation extremely easily without opening fracture site during an operation even in the cases several weeks after the injuries.

Materials and Methods: Four cases of metacarpal neck fracture that were irreducible by the traditional reduction method even under anaesthesia were investigated. Through a minimal skin incision, the dorsal capsule of the MP joint was punctured at proximally attached portion along the extensor tendon. A surgical sound was inserted into the joint close to the dorsal capsule not to injure the joint surface and then elevated dorsally to correct the angulation. The fragment was fixed intramedullarily by Foucher’s modification method.

Results and Conclusions: Operations were done average of 24.2 days after the injuries. Angulation angle compared with
non-injured side was corrected from 38.8 to 1.0 degree without any difficulty in all cases. Fragments were united 5.4 weeks after the operations. We recommend this technique for irreducible metacarpal neck fracture during an operation.