[Objective] To investigate the clinical efficacy of single intramedullary Kirschner wire fixation for the treatment of fracture of the fifth metacarpal neck after internal fixation. [Methods] From January 2015 to June 2021, 10 cases of refracture of the fifth metacarpal neck were treated by single 2.0mm intramedullary Kirschner wire fixation. The perioperative, follow-up and imaging data were summarized. [Results] All studied patients were successfully completed with no serious complications such as reduction loss, infection, bone nonunion, tendon stimulation and joint stiffness. The operation time was 15-25 min, and the average operation time was 18.60±2.88 min. Follow-up was 3-6 months and the average follow-up time was 4.90±1.10 months. VAS score, ROM score and DASH score of 10 patients were significantly improved (P<0.001). In terms of imaging, the excellent rate of alignment of 3 months after operation and at the last follow-up was 90%. The healing rate of 3 months after surgery was 40%. and the mean healing time was 4.10±1.10 months. The healing rate was 100% at the last follow-up (P<0.001). [Conclusion] The clinical efficacy of single intramedullary Kirschner wire fixation in the treatment of the fifth metacarpal neck refracture is satisfactory.