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Background: Injuries to the metacarpal bones are widespread and may severely limit a person's ability to go about their everyday lives. Unstable fractures usually need surgical intervention. Objectives: This study aimed to investigate how well Kirschner wires percutaneous fixing improves the prognosis of patients with unstable metacarpal fractures. Patients and methods: Fifteen patients with unstable metacarpal fractures were included in this study. They were treated by percutaneous fixation at Sharm El Sheikh Hospital through the period from 2017 to 2019. Nine patients in group 1 had antegrade intramedullary bouquet fixation and six in group 2 had transverse pinning. The results were evaluated using the total active movements (TAM) score after clinical and radiological follow-ups. Results: The mean patient age was 33.26 years. There were no statistically significant differences between the groups when it came to the intervals of time before fixation (p=0.64) and time until union (p=0.44). Results showed that both group 1 (76.77%) and group 2 (66.66%) when evaluated using TAM scores (p=0.26), had very good results. There were also no statistically significant differences between both groups in terms of the duration of follow-up or surgical complications (p=0.39 and p=0.35 respectively). Conclusion: There were no major variations in clinical or radiological outcomes between intramedullary and transverse pinning approaches when it comes to percutaneous fixation with Kirschner wires for unstable metacarpal fractures. Both methods provided equivalent results. [ABSTRACT FROM AUTHOR]