Plate fixation effective for closed multiple metacarpal fractures
MedWire News: Closed ipsilateral multiple metacarpal fractures can be effectively treated using plate fixation, suggest study findings showing this technique provides rigid fixation for early mobilization and good functional outcomes.
Close multiple metacarpal hand fractures are considered highly unstable and are prone to poor functional outcomes compared with open single metacarpal fracture. Indeed, results of closed treatment in the small percentage of patients with unstable hand fractures remains unsatisfactory.
Ashwani Soni (Post Graduate Institute of Medical Education and Research, Chandigarh, India) and colleagues therefore investigated the feasibility of treating multiple metacarpal fractures with mini fragment plates and screws.
In total, 21 patients with closed ipsilateral multiple metacarpal fractures were treated with open reduction and internal fixation using mini fragment plates.
Functional outcomes were assessed using the American Society for Surgery of the Hand (ASSH) Total Active Flexion (TAF) score and the Disabilities of the Arm, Shoulder, and Hand (DASH) scoring system. Patients were followed-up for an average of 1 year after surgery.
The researchers found that bone union occurred in all patients, at an average of 6.22 weeks after treatment. Final functional outcome, as assessed by ASSH TAF score, was excellent in 18 patients, good in two patients, and poor in one patient. Average DASH score was 8.47 out of a possible 26 points.
Deep infection was seen in two patients, and was managed with daily dressings and antibiotics. Of these two patients, one had four metacarpal fractures and other had three. Superficial infection was seen in three patients and was managed with daily dressings and antibiotics.
No cases of implant breakage, tendon irritation, or angular or rotational displacement were seen. None of the patients required removal of the implant.
"Plate fixation is a good option for treating closed multiple metacarpal fractures, providing rigid fixation for early mobilization and good functional outcome," conclude the authors in the Journal of Orthopaedic Traumatology.
By Ingrid Grasmo