Conclusion
Although most metacarpal fractures can be managed with closed reduction and immobilization, some unstable fractures will require operative stabilization. Operative fixation can be directed by the location and geometry of the fracture pattern. The mainstay of treatment consists of Kirschnerwire fixation (transverse, crossed, or intramedullary), cerclage or intraosseous wiring, miniplate or screw fixation, and external fixation. Throughout this review period, there have been multiple case series reporting the outcomes of numerous fixation techniques and biomechanical studies that give some insight into the ideal fixation construct. Prospective comparative studies will help provide evidencebased guidelines for treatment and optimal fixation methods of various metacarpal fractures.