Management of Metacarpal and Phalangeal Bone Fractures of the Hand

Abstract

Background: Hand fractures are one of the most commonfractures presenting at accident and emergency units. Becauseof the complexity of the hand; management of hand fracturescan be very challenging. Fixation of hand fractures can bedone by multiple methods including percutaneous K-wiresfixation and open reduction and internal fixation with eitherinterosseous wiring or mini plate and screws. This comparativeclinical study is to review the indications and long term resultsof each method.Methods: Thirty patients with hand fractures were includedin our study, ten of them treated with percutaneous K wirefixation (group A), another ten patients were treated withopen reduction and internal fixation with interosseous wiring(group B)and the last ten patients were treated with openreduction and internal fixation with miniplate and screws(group C). The duration of this study was for eleven monthswith patient's age ranging from 15-50 years old. The type ofsurgical intervention used was determined according to thefracture pattern.Results: All patients treated in this study had clinical andradiological union by the 10th week. Patients treated withpercutaneous K wire fixation had better range of movementand earlier return to work with less complications than patientstreated with open reduction and internal fixation with interosseouswiring or mini-plate and screws.Conclusion: Percutaneous fixation of unstable metacarpaland phalangeal fractures is a reliable and safe method for themajority of fracture patterns with higher ROM and lesscomplications in comparison with the other two methods.