Functional results of osteosynthesis with mini-plate and screws in metacarpal fractures

AbstractObjectivesTo evaluate the radiological and functional results of osteosynthesis with mini-plate and screws in metacarpal fractures.MethodsIn our study 43 patients who were operated between 2009 and 2012 were included. The patients were followed-up for (19.76±5.61) months. The mean age of patients was (31.11±7.81) years (7 females, 36 males). The fracture types were oblique for 19 patients, spiral for 15 patients and transverse for 9 patients. The patients were operated after a mean of 3.4 d (range 3 h-6 d) after the fracture had occurred. Patients were immobilized for 2 weeks with a splint after surgery. Passive joint movements were started on the third days, and active joint movements were started in the second week. Rehabilitation of all patients was done in the same center with supervision of the same physiotherapist. The patients were assessed by total joint range of movement of the finger, grasping strength and Quick-DASH scores.ResultsNo significant differences were detected between fingers of the operated hand with same finger of the healthy hand according to total joint range of movement. Total joint range of movement values were measured perfect for 38 patients, good for 4 patients and medium for 1 patient. There were no significant differences with the corresponding finger on the opposite healthy side according to grasping strength. Soiling in the wound dressing was observed in 1 patient but there was no active drainage. Soiling of the wound dressing disappeared after 3-5 d of treatment with antimicrobial agent. Bone union was observed in all patients in a mean of 6 weeks (range 5-7 weeks). The time to return to work was (31.6±8.9) d after the surgical treatment of the fracture.ConclusionsMini-plate and screws fixation of unstable metacarpal fractures produces anatomical reduction of fractures with stabilization that is rigid enough to allow early mobilization, thereby preventing stiffness and hence good functional results