Functional Outcome of Closed Metacarpal Fractures Treated With Mini Fragment Plates and Screws

Abstract

BACKGROUNDMetacarpal fractures are common in adolescents and young active individuals. Mostly these are treated by conservative methods. In unstable fractures where closed reduction and final outcome are unsatisfactory, there are multiple surgical options for treating metacarpal fractures like K-wire fixation, interosseous wiring, plate osteosynthesis, etc. In this study, we assess functional outcome of closed metacarpal fractures treated with plates and screws. MATERIALS AND METHODSBetween 2014 and 2016, 20 cases of closed metacarpal fractures were studied. Fracture was approached by dorsal incision. Plate configurations were chosen according to the fracture pattern (straight plate for shaft fractures, T or L configured plates were used for periarticular fractures) and fixed with screws. Post-operative physiotherapy and followup carried out. RESULTSIn our study, all the cases showed bone union (100%). The functional result assessed by American Society for Surgery of the Hand (ASSH) Total Active Flexion score showed excellent result in 80% of the patients (16 of 20 cases), good in 10% of cases (2 of 20 cases). Stable and rigid fixation allowed early mobilisation of fingers thereby preventing stiffness and achieved overall good functional results. Although there were 10% (2 cases) of superficial infections, all settled with regular dressing and antibiotics without affecting final functional outcome. The overall results are satisfactory. CONCLUSIONPlate and screw fixation is a good option for treating closed unstable metacarpal fractures, where other modalities of fixation are less effective. The rigid stable fixation provided by plating which withstands load without failure allowed early mobilisation and achieved good functional results.

Functional Outcome of Mini Implants in Closed Metacarpal Fractures

“…There were 5 diabetic patients, 4 hypertensive patients and 6 smokers in this study group. The commonest mode of injury was road traffic accident similar to a study by Pugazhenthi et al 21 .…”

“…The average union time in our study were 13.3 weeks (1 ½ month -6 months). The union time in another study was 7.2 weeks by Pugazhenthi et al 21 . We had three cases with delayed union in our study which were influenced by history of smoking with significant p-value of 0.01.…”