Effect of Non-Thumb Metacarpal Fractures on the functional outcome of primary Flexor tendon injuries in the Hand

Abstract

Background: Metacarpal fractures account for almost 10% of all upper limb skeletal injuries. It is commonly known that while treating hand and metacarpal fractures, consideration must be given to both soft tissue healing and fracture healing since good outcomes necessitate the restoration of both tissues' functional integrity. The aim of this study was to evaluate the effect of non-thumb metacarpal fractures on functional outcome of flexor tendon injury. Patients and methods: This study included twenty-four cases, their ages ranged from 20- 52 years, 18 males and 6 females. Injury was mainly in the 5th finger in11 cases in this study, the main mechanisms of injury were machinery (41.7%) and assaulted (20.8%), (16 cases 66.7%) of injuries occurred in the dominant hand. The main site and commonest pattern of fracture were in shaft and transverse respectively. Most patients were injured in Zone III. 19 patients were managed by K- wire and 5 patients treated by ORIF using miniplates and screws. The follow up and evaluation of cases was for 6 months. Results: The improvement of hand motion was good in 10pt (41.7%), fair in 8(33.3%) and poor in 6(25%). For metacarpal fracture we used American Society for Surgery of the hand (ASSH) was excellent in 10pt (41.7%), good 6(25%), fair 6(25%) and poor 2(8.3%). Conclusion: The main technique used in this study was that of K-wire fixation as they were easier to apply, available and versatile with less operative time than open reduction internal fixation (ORIF) using mini-plates and screws.