Background: Unstable metacarpal and phalangeal fractures
represent more than one third fractures of the hand. The severe
the trauma, the more grave the fracture that herald perfect
management is needed.
Objective: Assessment of the clinical and radiological
outcomes of metacarpal and proximal phalangeal fractures in
patients who underwent open anatomic reduction and fixation
with plate and screws or by intramedullary K wire fixation.
Patients and Methods: Twenty five patients with unstable
metacarpal and phalangeal fractures were treated; in group I
12 male patients operated by plate and screw fixation and
group II 13 male patients operated by intramedullary K wire
fixation. For the two groups total active motion "TAM, DASH
score, postoperative lateral angulation, loss of reduction and
radiological healing were assessed.
Results: There was a non-significant difference between
group I (Plate and screw fixation) and group II (Intramedullary
nail fixation) as regard the follow-up period or association
between loss of reduction and removal of hard ware (p>0.05).
Group I showed a significant increase in the mean values of
surgery duration and TAM (p<0.05), accompanied by a significant
reduction in the mean values of DASH score, postoperative
lateral angulation and radiological healing in comparison
to those group II (p<0.01).
Conclusion: The operative duration of plates and screws
fixation was longer than that of K wire fixation, but it had
perfect stability with early mobilization, therefore, when
possible it is preferred to be the first line of choice in management
of unstable metacarpal and proximal phalangeal bone
fractures