The Role of Mini-Plate and Screws in Metacarpal Shaft Fracture Fixation: A Clinical and Functional Study

Ahmed, Ali A; Hifny, Mahmooud A; Omar, Mohamed A; Said, Samia Mohamed Ahmed

doi:10.21608/ejprs.2022.269078

The Role of Mini-Plate and Screws in Metacarpal Shaft Fracture Fixation: A Clinical and Functional Study

Document Type : Original Article

Authors

¹ The Department of Plastic Surgery, Faculty of Medicine, Qena University

² General Surgery, Faculty of Medicine, South Valley University

³ Plastic Surgery, Faculty of Medicine, Sohag University

10.21608/ejprs.2022.269078

Abstract

Background: Hand fractures account for 10% of all broken
bones, with metacarpal fractures accounting for one-third of
all hand breaks. Mini-plates and screws may offer firm fixation,
allowing for early joint mobility and hence excellent functional
outcomes while preventing the problems associated with
Kirschner-wires fixation.
Objectives: To evaluate the clinical and function outcome
of mini-plates and screws in the management of isolated,
healed, single-digit metacarpal shaft fractures along with
long- term functional assessment of the fractured hand by the
disabilities of the arm, shoulder and hand (DASH) outcome
questionnaire.
Patients and Methods: This is a prospective cohort study
that conducted between April 2021 and March 2022 on patients
presented with metacarpal shaft fracture. The primary outcomes
evaluation includes: Presence of complications related to
fixation technique, time of radiographic fracture union, metacarpophalangeal
joint's range of motion (ROM) and the Total
Active Flexion (TAF) score.
Results: All fractures in all patients (30 cases) had a
successful union (100%) ranging between 8-12 weeks with
a median of 10 weeks. The mean ROM of the respective MP
joint was 74±8.96° at 3 month post-operative, which improved
significantly, to 85.6±3.98° (p < 0.004) at 6 month follow-up.
The total active flexion (TAF) score showed that (73.3%) of
our patients have excellent results, while it was good in (20%)
patients, and fair in (6.7%) patients. The mean quick DASH
score was 8.36±4.86, which significantly decreased to
6.47±4.08 at the end of follow-up period.
Conclusions: Mini-plate and screws is a suitable approach
for unstable metacarpal fracture fixation. The employment of
mini-plate and screws provide rigid stable fixation which
enables early hand movement and achieving good functional
outcomes

Keywords

Main Subjects

Hand and Upper Limb Surgery'

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