Title: A Study on Functional Outcome of Various Modalities of Internal Fixation of Metacarpal and Phalangeal Fractures of Hand - A Prospective Study
Authors: V. James Sundar Singh, Prof. Dr A.Senthilnathan, Dr R.Prabhakar, Dr P.S.Balamurugavel, Dr M. Viswanathan, Dr M.Harrivishnu, Dr V.Manooj Kumar
DOI: https://dx.doi.org/10.18535/jmscr/v4i10.111
Abstract
Background: Fractures of the bones of the hand are among the commonest fractures in humans but their management varies widely in different regions of the world. The variability is due to many reasons including availability of resources, social factors, geographic constraints, surgeon’s preference and experience and local practice patterns. Hand fractures constitute 14 to 28% of all visits to hospital following trauma by various means. These fractures are often neglected or treated as minor injury and results in major disability.
Methods: This study included 40 patients with unstable metacarpal and phalangeal fractures which were internally fixed by various modalities at Rajah Muthiah Medical College. The outcome was analysed with special emphasis on active movement of fingers at metacarpophalangeal and interphalangeal joints.
Results: We assessed the functional outcome with American Society for Surgery of the Hand (ASSH) score and Total Active Flexion (TAF) score.100% union achieved in all cases with average period of union as 7.2 weeks, functional outcome was excellent in 80%, good in 10%, fair in 5% and poor in 5%. 8 persons developed complications of which 4 had infection and the other 4 had joint stiffness.
Conclusion: Various modalities of internal fixation is a good option for treating unstable metacarpal and phalangeal fractures as it allows early mobilisation and good functional results provided detailed clinical and radiological assessment of the fracture, careful pre operative planning, meticulous dissection, precision in surgical technique and choosing the correct implant are strictly followed.
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