One hundred patients with fractures and dislocation or subluxation of the base of the fourth and/or fifth metacarpals were randomized to receive either trans-carpometacarpal joint microplate fixation (n=50) or non-trans-carpometacarpal joint fixation (n=50). The primary outcomes were handgrip strength and total active motion (TAM) of the ring and little fingers. Secondary outcomes included DASH scores, VAS scores, and Mayo wrist scores, assessed at 3, 6, and 12 months. Overall, both groups showed similar outcomes at 3 and 12 months, but at 6 months, the non-transarticular group had significantly better grip strength, TAM, DASH, and Mayo scores. These findings suggest that non-trans-carpometacarpal fixation may lead to faster intermediate functional recovery without compromising long-term results.