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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2000, Number 1

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An Med Asoc Med Hosp ABC 2000; 45 (1)

Surgical treatment of metacarpal shaft fractures

Juárez RCS, Fernández VJM, Procell VCR, Cárdenas TMB

Language: Spanish
References: 17
Page: 21-26
PDF size: 591.49 Kb.


ABSTRACT

The surgical management of metacarpal shaft fractures has three main objectives: to correct shortening, dorsal angulation and rotation. Different methods of fixation may be used depending on the type of fracture. Internal fixation with plates and plates with interfragmentary screws provide a rigid fixation and early active motion can be established, however the tissue damage and wide deperiostization involved may create postoperative fibrosis which limits functional results. We propose Kirschner wire fixation, closed or open, as a method with similar or better functional results. We included 20 patients with 26 metacarpal shaft fractures treated at the ABC Hospital from January 1994 to May 1999. A comparative study between the two groups with 9 fractures each, was performed. Group A: Kirschner wire fixation percutaneous or open. B: Open reduction and Internal Fixation with plates and screws. Isolated screw fixation (Group C) with 8 cases was not statistically analyzed. There were no major statistical differences between group A and group B; regarding range of motion, strength, pain and working ability. Group B had a shorter period of immobilization. If stable osteosynthesis can be achieved with interfragmentary screws (Group C) the functional results are good and the immobilization time is shorter than with Kirschner wire fixation. Kirschner wire fixation is less expensive and the functional results are similar to the plate and plate with interfragmentary screw fixation.


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