Evaluation of outcomes after management of metacarpal and phalangeal fractures of hand

Abstract

Background: Fracture and dislocation of hand most frequently encounter in orthopaedics injuries fracture of phalanges and metacarpal are approximately 10% of all fracture of skeleton system phalangeal fracture comprise 46% of hand fractures, metacarpal fractures 38% and fifth metacarpal fracture 9.7%, distal phalangeal fractures are most commonly encounter fracture of the hand. The annual incidence of phalangeal fracture in hand is 1% in normal population. And these injuries account for between. 2% and 3% of all patient visiting in accident and emergency unit thumb and middle finger are most frequently injured because they extend most distally during work activity. Aim & Objectives: To evaluate the structural and functional outcomes and the results of operative and conservative management of metacarpal and phalangeal fractures of hand. Methods: The present study comprises of 62 patients of closed fractures of metacarpal and phalanx treated in the Department of Orthopaedic Surgery, Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital Rewa (M.P.) in a span of two years. Evaluation of outcomes after management of metacarpal and phalangeal fractures of hand was done. Results: We achieved 24 (85.7%) excellent and good results in conservative method for metacarpal fractures and 10 (83.33%) operative methods. In Phalangeal fractures 09 (90.0%) excellent and good results were achieved in conservative method and 10 (83.34%) in operative methods. Excellent and good grip strength was noted in 53 (85.33%) cases. Single digit involvement had better TAM then multiple digits involvement. Poor results were noted in metacarpal fractures in 04 (14%) in conservative series and 02 (16.0%) in operative series. Poor results were seen in phalangeal fractures in 01 (10%) in conservative series and 02 (16.66%) in operative series. Most common complication was finger stiffness in conservative method and pin site infection in operative methods. Conclusion: Both conservative and operative methods (surgical stabilization) for metacarpal and phalangeal fractures of hand gave good functional outcomes, depending on the fracture pattern for treatment option, single digit involvement are important determinants to achieve a better grade of total active range of motion.