DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20214491

Evaluation of functional outcome of metacarpal fractures managed by operative techniques: a hospital based study

Amit Kumar, Sanjeev Gupta, Vinay Badyal

Abstract


Background: Metacarpal fractures comprise approximately 35.5% of cases in daily emergencies, mostly due to road traffic accidents, fall, and assault. The main goal of treatment is to achieve the strong bony union without any functional disability. Aim of the study was evaluation of functional outcome of metacarpal fractures managed by operative techniques and to compare the efficacy of different operative techniques.

Methods: A total of 50 patients managed by various operative techniques by using k-wires, screws and plates. Functional outcome was assessed by using total active movement (TAM) and disabilities of the arm, shoulder and hand (DASH) scoring system at 6th week, 3rd month and at 6th month.

Results: A total 47 fractures united and three fractures mal-united at the time of final assessment. Overall excellent and good results were achieved in 94% cases.

Conclusions: Our finding suggests that open reduction and internal fixation with k-wire is most preferable method among all other operative techniques.


Keywords


Metacarpal bones, TAM, DASH

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References


Kandasamy AA, Pheroz M, Kumar A, Krishna LG, Jain A, Grower R. Fractures of metacarpal bone: evaluation of functional outcome of open reduction and internal fixation with mini locking plate: a hospital based study. Int J Res Orthop. 2019;5:519-25.

Hove LM. Fractures of the Hand. Scandinavian J Plastic Reconstructive Surg Hand Surg. 1993;27(4):317-9.

Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am. 2001;26(5):908-15.

Mohammed R, Farook MZ, Newman K. Percutaneous elastic intramedullary nailing of metacarpal fractures: surgical technique and clinical results study. J Orthop Surg Res. 2011;6:37.

Lambotte A. Contribution a la chirurgie conservatrice de la main doms les traumatismes. Arch Franco Belges Chir. 1928;31:759-61.

Amidio PC. Fractures of hand and the wrist .In: Jupiter JB (ed) Flynn's hand surgery. William & Wilkins, Baltimore. 1991;122-85.

Stern PJ. Fractures of the metacarpals and the phalanges. In: Green DP, editor. Operative hand surgery, vol 1. Churchill Livingstone, New York. 1999;711-71.

Barton NJ. Fractures of the hand. J Bone Joint Surg Br. 1984;66:159-67.

Drenth DJ, Klasen HJ. External fixation for phalangeal and metacarpal fractures. J Bone Joint Surg Br 1998;80:227-30.

Brenwald J. Bone healing in the hand. Clin Orthop Relat Res. 1987;214:710.

Shehadi SI. External fixation of metacarpal and phalangeal fractures. J Hand Surg Am. 1991;16(3):544-50.

Itadera E, Hiwatari R, Moriya H, Ono Y. Closed intramedullary fixation for metacarpal fractures using J shaped nail. Hand Surg. 2008;13(3):139-45.

Ozer K, Gillani S, William A. Comparison of intermedullary nailing versus plate screw fixation of extra articular metacarpal fractures. J Hand Surg Am. 2008;33(10):1724-31.

Lieber J, Harter B, Schmid E, Kirschner HJ, Schittenbecher PP. Elastic stable intramedullary nailing (ESIN) of pediatric metacarpal fractures: experiences with 66 cases. European J Ped Surg. 2012;22(04):305-10.

Blazar PE, Leven D. Intramedullary nail fixation for metacarpal fractures. Hand Clinics. 2010;26(3):321-5.

Hong SJ, Lee HJ, Kim JY, Eo SR, Cho SH. K wire breakage during metalware removal due to a defective K wire shaft. Arch Plastic Surg. 2013;40(5):655-7.

Crawford GP. Screw fixation for certain fractures of the phalangeal and metacapal. JBJS. 1976;58(4)487-92.

Zhu H, Xu Z, Wei H, Zheng X. Locking Plate Alone versus in Combination with Two Crossed Kirschner Wires for Fifth Metacarpal Neck Fracture. Scientific Rep. 2017;7:46109.

Souer JS, Mudgal CS. Plate fixation in closed ipsilateral multiple metacarpal fractures. J Hand Surg Eur. 2008;33(6):740-4.

Gupta R, Singh R, Siwach RC, Sangwan SS. Evaluation of surgical stabilization of metacarpal and phalangeal fractures of hand. Indian J Orthop. 2007;41(3):224-9.

Greeven AP, Bezstarosti S, Krijnen P, Schipper IB. Open reduction and internal fixation versus percutaneous transverse Kirschner wire fixation for single, closed second to fifth metacarpal shaft fractures: a systematic review. Eur J Trauma Emerg Surg. 2016;42:169-75.

Lee SK, Kim KJ, Choy WS: Modified retrograde percutaneous intramedullary multiple Kirschner wire fixation for treatment of unstable displaced metacarpal neck and shaft fractures. Eur J Orthop Surg Traumatol. 2013;23:535-43.

Kelsch G, Ulrich C. Intramedullary k-wire fixation of metacarpal fractures. Arch Orthop Trauma Surg. 2004;124:523-6.