Introduction: Metacarpal fractures account for upto 10% of all body fractures and 36% of all hand fractures in adolescents, young adults, and active adults. Fractures of the metacarpal shaft and neck are common in all metacarpal fractures after direct trauma, roadside accidents, or sports injuries. The ratio of the shaft to the neck is 1:2. Closed reduction and plaster of paris cast can be used to treat the majority of these fractures conservatively. Unstable and comminuted fractures necessitate surgery. Aim: To compare the clinical, functional and radiological outcomes in antegrade intramedullary fixation and transverse pinning of metacarpal fractures in patients of unstable and displaced metacarpal shaft and neck fractures. Materials and Methods: A single-institutional prospective interventional study identified 60 cases of metacarpal fractures between November 2019 to August 2021. Each of the cases met the inclusion criteria for closed extra-articular fractures, displaced and unstable fractures of the metacarpal bone. The patients were divided into two groups having 30 subjects each, randomly allotted to two groups (Antegrade intramedullary K-wiring and Transverse Pinning). Outcomes were compared for range of movement by the American Society of Hand Surgeons Total Active Motion score (ASSH TAM), Visual Analog Scale (VAS), and radiological parameters (Angulation). Patients were followed-up for 12 weeks. Complications were listed in terms of pin site infection. Results: Most of the patients were found to be in the third decade of life. The fracture union was achieved at 8±2 weeks. Clinical evaluation done by VAS score which was found to be statistically insignificant between two groups (p-value=0.243). Radiological assessment evaluated by measuring postoperative angulation between two groups was found to be statistically insignificant (p-value=0.248). Difference in functional evaluation between the two groups done by ASSH TAM was found to statistically significant between the groups (p-value=0.036). Conclusion: Both antegrade intramedullary K-wiring and transverse pinning demonstrate good and comparable results for extra-articular neck and shaft metacarpal fractures. However, the former is superior in terms of final range of motion as per ASSH TAM score.

No abstract

Introduction: Metacarpal fractures are among the most common fractures encountered in the Emergency Department. They can be treated by Conservative methods as well as operative methods. Operative methods usually lead to better clinical results. This study aimed to evaluate the clinical results using the Total Active Flexion score by the American Society of Hand Surgeons (ASSH) Aim of study: To evaluate the functional outcome of Metacarpal shaft fractures treated with Mini Plates Materials and Methods: This prospective study was conducted in a tertiary health care Centre from January 2020 to June 2021. Inclusion criteria were patients with closed, displaced metacarpal fractures of fingers 2 to 5. 50 patients were included in the study. Age was between 20-50 years Results: 50 patients were included in the study. Half (25) were males and half (25) were females. 80 percent of the patients (40) had fractures in the dominant hand. Total active flexion measured was excellent in 35 patients, good in 10 patients, and fair in 5 patients Conclusion: Use of Mini plates leads to early post-operative rehabilitation and good clinical outcome as measured by the Total active Flexion score given by ASSH.