![]() ![]() Shortening of 2 to 5 mm is a relative indication for surgery, due to mild loss of grip strength. ![]() These include rotational deformity of over 5°, fracture translation above 50%, and shortening exceeding 6 mm. 4Īlthough most can be treated conservatively with expected good results, several indications are agreed upon for surgical treatment. 1 - 3 Of these, 58% were located in the area of the metacarpal shaft, as shown in a recent study. Metacarpal fractures occur commonly and account for 36% to 42% of all fractures around the hand. Our study supports the use of this method over intramedullary pinning for metacarpal shaft fractures. Conclusions: Fixation with locking plates allows earlier mobilization without need for splinting. Radiographic bone healing time (59 vs 50 days) and operative time (58 vs 41 minutes) were both significantly longer in fractures fixated by plates. Patients in the plate group were found to have significantly improved outcomes in total range of motion of the operated digits (loss of 4° extension, 10° flexion, and 14° total vs 10° extension, 19° flexion, and 29° total), grip strength (93% vs 83% of contralateral hand), rotational deformity (5 digits, 1° vs 15 digits, 6°), and DASH score (10.5 vs 15.6). Both groups had similar characteristics and preoperative fracture patterns on radiograph. Results: Thirty patients with 39 fractured metacarpals treated by pinning were compared with 29 patients with 35 fractured metacarpals treated by locking plate and screws. Evaluation included range of motion measurements for all fingers compared with the contralateral hand comparison of grip strength finger alignment and rotation Disabilities of the Arm, Shoulder and Hand (DASH) score and radiographic measurements of fracture reduction and healing. All fractures were fixated by pinning between years 20 and by locking plates and screws between 20. Methods: Patients operated on for closed shaft fractures of metacarpals 2-5 were examined at least 1 year after injury. This study compared outcome measurements of these two techniques. Background: Metacarpal shaft fractures that necessitate surgery are frequently fixated with either intramedullary pins or plates and screws. ![]()
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