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

Abstract

Background: Metacarpal fractures represent about one-third of all hand fractures. The principles of fracture management are to restore full hand function and minimizing additional soft tissue injury. Our study aimed to evaluate the functional and radiological outcome of metacarpal fractures, treated by open reduction and internal fixation using mini-plate and screws.
Methods: A prospective cohort study included 12 patients with metacarpal fracture were operated at Orthopedic Surgery Department, Zagazig University Hospitals. All patients were managed by open reduction internal fixation (ORIF) and fixed using mini-plates and mini-screws and were evaluated both clinically and radiologically. The functional outcome was evaluated by TAM score and Quick DASH score.
Results: The mean patient’s age was 35.67 ±10.16 years ranged from 27-69 years. According to AO/OTA classification the most common fractures were 77.3.4.2C followed by 77.1.1C and 77.4.2A by 16.7% for each one. The mean TAM score was 230.3 ± 39.1 ranged from 125 to 255. 83.4% of patients were satisfied. According to Quick DASH score, 25% of patients (3 patients) were unsatisfied, two of three were had fair and one had poor satisfaction, while about 75% were satisfied. Most of the studied group had grip strength between 80 and 89% in compare to the contra-lateral side. While 4 patients had grip strength more than 90% in compare to the normal hand and one patient had grip strength < 70%.
Conclusion: Plate osteosynthesis is an excellent choice for treatment of metacarpal bone fractures. Fixation of metacarpal fractures by mini-plate and screws lead to anatomical reduction of fractures with stabilization that is rigid enough to allow early mobilization and preventing stiffness with good functional outcome.