J Korean Soc Surg Hand.  2013 Sep;18(3):103-110. 10.12790/jkssh.2013.18.3.103.

Outcomes of Unstable Extraarticular Metacarpal Fractures Treated with Low Profile Titanium Plate System

• Lee JH
• Chung DW
• Han CS
• Cho YJ

• KMID: 2194139
• DOI: http://doi.org/10.12790/jkssh.2013.18.3.103

Abstract

PURPOSE
The purpose of this study was to evaluate clinical results for open reduction and internal fixation of unstable extraarticular metacarpal fractures using low profile titanium plates.
METHODS
Sixty-two consecutive patients (76 metacarpals) with unstable extraarticular metacarpal fractures who prospectively underwent internal fixation with plating were enrolled. Minimum follow-up was 1 year. There were 48 males and 14 females; average age was 39 years (range, 15-71 years). The location of the fractures was shaft in 65 metacarpals and the type was transverse in 22 cases, oblique in 46 cases, and communited in 8 cases. Of the 62 patients, 11 were open; 9 of these had additional soft tissue injury. The surgical outcome was assessed by clinical and radiographic outcomes and complications.
RESULTS
Bone union was successfully achieved in all patients on the average period of 6.4 weeks. The final range of total active motion was excellent for 64 cases, good for 6 cases, fair for 5 cases, and poor for 1 case. Postoperative complications occurred in 9 patients (15 metacarpals). Statistical analysis revealed that patient age, occupation, multiple metacarpal fractures, and soft tissue injury were significantly correlated with incidence of complications at last follow-up.
CONCLUSION
Low profile titanium plating showed the low complication rate and good results in treating unstable extraarticular metacarpal fractures.

Keyword

Metacarpals; Fracture; Internal fixation; Plating

MeSH Terms

Follow-Up Studies
Humans
Incidence
Male
Metacarpal Bones
Occupations
Postoperative Complications
Prospective Studies
Soft Tissue Injuries
Titanium
Titanium

Figure

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  Fig. 1. (A) Intraoperative finding using a mosquito in order to reduce the fracture. (B) Temporary K-wire fixation to keep the fracture reduction. (C) Photo showing a plate fixation. (D) Intraoperative photo showing complete coverage of metacarpal bone with the periosteum to prevent the tendon adhesion after plate fixation.

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  Fig. 2. (A) Preoperative radiographs show an unstable, dorsal angulated metacarpal shaft fracture of small finger. (B) Immediate postoperative radiographs. (C) Radiographs at 6 months follow-up show a good bony union.

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