Management of oblique and spiral metacarpal fractures with mini plate and screw versus screws only

Abstract

Background Fractures involving the tubular bones of the hand are the most frequent of all skeletal injuries. The choice of treatment depends on a variety of clinical and radiological factors. The goal of treatment is restoration or preservation of the hand function. Objectives To compare the results of mini plate plus screw versus screw only in oblique and spiral metacarpal fractures. Patients and methods This is a randomized clinical trial that included 40 patients with oblique and spiral metacarpal fractures who divided into two groups according to management: either fixation by mini plate and mini screws (20 patients) or fixation by mini screws only (20 patients). Quick-DASH and total active motion (TAM) scoring systems were used to evaluate all patients on 4th, 12th, and 24th weeks postoperative. Results The mean value of TAM score in the mini plate group was significantly higher than screws only group at 4th week postoperative (P=0.007) while it was nonsignificantly higher at 12th and 24th week postoperative. Also, the mean value of DASH score in the mini plate group was significantly lower than screws only group at 4th week postoperative (P=0.0001) while it was nonsignificantly lower at 12th and 24th week postoperative. The total number of complicated patients in the mini plate group was 2 patients (10%) while it was 5 patients (25%) in the screw only group with significant difference between both groups (P=0.0001). Conclusion Although mini plate and screw group showed early mobilization of the affected hand and has significant Quick-DASH and TAM scores at 4th week postoperative, both groups revealed the same functional outcomes at the end of follow-up.