Objective To verify the effectiveness of intramedullary fixation for the fractures of the neck and shaft of the fifth metacarpal bone. Methods Fifteen patients with displaced neck and shaft fractures of the fifth metacarpal who received operative treatment were included in a retrospective cohort study. All patients had close reduction and intramedullary fixation. Data was analysed from medical records and a clinical and radiological outcome evaluation was performed. Results Median time for follow-up was 6.4 months (range, 3 to 24 months). All fracture went on to heal. At the final follow-up, all patients had full range of motion of the fifth finger. Only one complication occurred:dorsal cutaneous branchof ulnar nerve irritation in one case. There was no infection. Conclusion From our clinical and radiological data we conclude that close reduction intramedullary fixation for displaced fractures of the neck and shaft of the fifth metacarpal affords excellent results and thus should be preferentially considered for these types of fracture.%目的：探讨应用髓内针内固定术治疗第5掌骨颈和掌骨干骨折的疗效。方法采用单枚髓内针固定方法治疗闭合性第5掌骨颈及掌骨干骨折15例。随访观察指标包括：骨折愈合时间、掌指关节活动度；影像学观察指标包括：掌骨成角及掌骨短缩。掌指关节活动度和影像学指标均与健侧进行比较。结果本组患者平均随访6.4个月（3～24个月）。术后6～8周，所有骨折均出现明显骨痂。最终随访时，患侧第5掌指关节活动度87.5°±3.4°，健侧88.8°±2.6°，差异无统计学意义。 X线结果显示所有骨折均愈合。患侧第5掌骨背侧成角5.9°±2.1°，健侧为4.7°±1.3°，差异无统计学意义；患侧第5掌骨长度（51.9±3.2） mm，健侧为（52.7±2.6） mm，两组间比较差异有统计学意义，第5掌骨平均短缩0.8 mm。所有患者均未出现切口感染、骨折不愈合。1例术后出现尺神经手背支刺激症状，骨折愈合拔针后症状改善。结论髓内针固定方式治疗第5掌骨颈和掌骨干骨折创伤小，固定强度好，并发症少，是治疗该类型骨折一种理想的治疗方法。
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