In situ transverse osteotomy and locked mini plate for the correction of metacarpal rotational deformity

Abstract

Objectives: We aimed to investigate the radiological and clinical results of transverse osteotomy and fixation applications in rotation deformities due to metacarpal malunion. Methods: A total of 18 fingers from 18 patients were enrolled in the study (14 males and 4 females). The average age of the patients was 32.8 ± 14.4 years (range: 18-58 years). The average follow-up duration was 19.7 ± 7.9 months (range: 7-36 months). All patients had a scissoring deformity which affected their daily activities or caused cosmetic problems. Results: In all patients, the scissoring and overlapping deformities improved and in all osteotomies union was achieved. A total range of motion for the DIP, PIP, MP and wrist joints was achieved in all patients. The average DASH score was 5.2 ± 5.6 (range: 0-21.7), and the average VAS score was 0.8 ± 0.9 (range: 0-3). The average grip strength was 40.5 ± 10.2 kg (range: 19-55 kg) and 94% of the healthy side. There was no statistically significant difference in grip strength compared to the healthy side (p = 0.23). 14 excellent and 4 good scores were obtained based on Büchler criteria. Conclusions: In situ transverse osteotomy and the locked miniplate method is effective and feasible in the treatment of metacarpal malunions with finger rotational deformities, given their ease of use, allowance of early movement, high union rates, and good results.