Operative Management of Metacarpal and Phalangeal Fractures.

ABSTRACT

Fractures of metacarpals and phalanges are probably the most common fractures in the skeletal system and are often neglected as minor injuries. Most of the fractures are treated conservatively but some form of fixation is often indicated in unstable fractures, intra-articular fractures, open fractures and multiple fractures. Various implants ranging from K-wires to mini-plates are used. A retrospective analysis of 50 cases of metacarpal and phalangeal fractures treated by different methods over a period of one year was undertaken. The study showed that right hand was more commonly involved. Most common mechanism of injury was fall and second ray was most commonly involved. Most common fracture pattern was transverse and K-wires were frequently used as mode of fixation followed by mini-plates. The patients were followed up at regular intervals and union was achieved in 98% of fractures. From our study we would emphasize that operative management of metacarpal and phalangeal fractures has definitely an advantage over the closed methods of treatment especially in displaced, unstable, comminuted, intraarticular, open and multiple fractures. Operative management of hand fractures should be undertaken only if a definite indication exists. Indiscriminate use of it should be avoided. The operative management of metacarpal and phalangeal fractures results in accurate reduction of the fracture and joints should be mobilised early following fixation to prevent stiffness of the fingers and regain the desired range of motion at the joint.