Fractures of metacarpals and phalanges are among the most common injuries seen in emergency departments, constituting between 14% to 28% of all visits. Though large number of hand fractures can be treated conservatively, but in some fractures like unstable, intraarticular and malrotated fractures, operative treatment is indicated. The present study was undertaken to evaluate the results of surgical stabilisation of metacarpal and phalange fractures of the hand.
Method: A total of 25 patients of metacarpals and phalanges fractures of hand were included in this prospective study during the period April 2010-July 2013. Fractures were fixed with various fixation method as indicated. I.e. ORIF with Plate, ORIF with Screws, CRIF with Kirschner wires or External Fixator. Final evaluation of patients was done at the end of six months, based on criteria for American society for Surgery of Hand.
Results: A total of 34 digits were involved in 25 patients. 32.35% of the fractures were spiral/ long oblique followed by 29.41% short oblique followed by comminuted and transverse fractures. Most of the patients were treated by Open reduction and internal fixation with plates and screws (47%) followed by fixation with screws and kirschner wire. A total of 12 minor complications were observed in 10 patients out of a total of 25. Finger stiffness was the most commonly observed complication. Overall end result was graded as acceptable in 97.03% (excellent to good) and non-acceptable in 02.94% (fair) cases.
Conclusion: In conclusion, our series suggests that in low-severity fractures treated with miniature plates and screws, very favourable outcomes should be expected. Screw fixation was observed to give excellent results in spiral fractures of metacarpals and phalanges, while fixing fractures with kirschner wires trans fixation of joints should be avoided to get optimum results. Early mobilization is the key to get excellent functional results in all hand fractures.