The goal of this study is to evaluate results of intramedullary screw fixation of metacarpal fractures while summarizing the pearls and pitfalls to maximize successful surgical outcomes in adults, Metacarpal fractures are third most common upper extremity fractures, Intramedullary screw Fixation is a fixation option that offers rigid stability, early active range of motion, and simplicity of insertion,

Inclusion Criteria:

• Adult patients.
• Metacarpal shaft fractures.
• Simple fractures.
• Recent fractures within 1-2 weeks.
• Isolated metacarpal fractures.

Exclusion Criteria:

• Pediatric fractures with open physis.
• Head-splitting fractures and Metacarpal basal fractures.
• Compound fracture increasing risk of infection.
• medical illness or mental disorders affecting the follow-up examination.
• Association with other fractures fixed by methods that limit early range of motion.
• pathologic fractures.