Would i need to have pins or plates in 5th metacarpal that rotated 40 degrees and 3 manipulations didn't work?

Metacarpal rotation: can affect the way the fingers overlap in the flex position. Any discussion of surgery should be framed in terms of the potential benefits versus the risks and potential complications. This is a very direct clinically driven question that needs to be discussed with your surgeon. However rotation is One important primary driver of the need for surgical treatment