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Clinico-radiological results of osteosynthesis of unstable fractures of tubular bones of hand using mini fragment plate and screw system.

Aamir Nazir Bhat, Tarsem Lal Motten, Faisal Naseer Mir, Nadeem Ali, Aabid Ahmad Rather, Mohamad Azhar Gilani.


Objective: Hand is a complicated and specialized unit of the body that functions to perform both hard laborious jobs as well as delicate fine activities. Deformities or stiffness of the hand from fractures of its bones can hamper these activities and hand function. The behavior of hand fractures is totally different from fractures elsewhere in the body with stiffness resulting from overtreatment and deformity from under treatment. The aim of this study was to evaluate the outcome of surgical stabilization with mini fragment plates and early rehabilitation in unstable fractures of the metacarpals or phalanges of the hand.
Materials and Methods: This prospective study was conducted in the Department of Orthopaedics from December 2019 to June 2021 and included 20 patients with unstable metacarpal and phalangeal fractures that were managed by open reduction and internal fixation using AO mini fragment plates and or screws. The final functional outcome was assessed at six months using a three criteria scoring system, namely, union, function based on total active movement (TAM) and associated complications.
Results: The age of the patients ranged from 20 to 74 years with a mean age of 32.9 ± 14.34 years. Ninety percent of the patients were males with road side accidents and blunt trauma being predominant mode of injury seen in 40 % of the patients. Of the 24 fractures in 20 patients, one patient had deep infection (osteomyelitis) and one had loss of fixation. Seventy five percent of the patients returned to work within 5-6 weeks. 91.6 % fractures had an excellent result and the remaining 8.4 % fractures had a poor score at the final follow up.
Conclusion: Open reduction and internal fixation of unstable fractures of the metacarpals and phalanges of the hand with mini-fragment screws and plates provides sufficient stability and strength which allows early rehabilitation for restoration of the hand function and simultaneous progression of bone union with least complications.

Key words: hand injuries; metacarpals; phalanges; mini fragment plates

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