Evaluation of surgical management of metacarpal fractures – A prospective clinical study

Abstract

Introduction: Metacarpal fractures constitutes between 14-28% of all visits to the hospital following trauma. Too often these metacarpal fractures are neglected or treated as minor injuries and results in major disability and deformity with permanent crippling of fine movements. A stable fracture fixation helps in restoring early mobilization. Early mobilization can prevent adhesions and is the key to good clinical outcome. Materials and Methods: Thirty patients with metacarpal fractures were surgically fixed with k-wire or plate and screw in our trauma centre. 24 males and 6 female patients were part of the study. The mean age was 38 years. Radiographs of affected hand, both AP & Lateral views were obtained before surgery, post- surgery, and at follow-ups. Results: Male patients in their 3rd decade following a road traffic accident fracturing right hand 4th metacarpal shaft was the common presentation. Transverse fracture pattern was most common. 70% of cases had excellent result, 20% patients with good results and 10% had fair result. Finger stiffness was the most frequently encountered complication. Conclusion: Displaced metacarpal fractures treated surgically by plate and screw or k-wire gives good result in terms of union, functional recovery and prevent stiffness. CRIF with k-wire shows faster union, faster recovery and lesser stiffness compared to ORIF with k-wire and plates and screws. Multiple metacarpal fractures in same hand treated surgically gives better results than those treated conservatively. Metacarpal fractures fixed rigidly with plate and screw can be mobilized much earlier then those with k wire fixation.