Surgical Treatment of Metacarpal and Phalangeal Fracture with Rotational Malalignment

Lee,  Soohyun; Lee,  Soonchul; Lee,  Jun Ku; Sim,  Youngsuk; Choi,  Dae Sung; Han,  Soo Hong

doi:2017.22.3.189

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Arch Hand Microsurg > Volume 22(3); 2017 > Article

Original Article

Journal of the Korean Society for Surgery of the Hand 2017;22(3):189-195.
Published online September 30, 2017.
DOI: https://doi.org/10.12790/jkssh.2017.22.3.189

Surgical Treatment of Metacarpal and Phalangeal Fracture with Rotational Malalignment

Soohyun Lee, Soonchul Lee, Jun Ku Lee, Youngsuk Sim, Dae Sung Choi, Soo Hong Han

¹Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea. hsoohong@hanmail.net
²Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University, Seoul, Korea.

Received: 6 June 2017 • Revised: 3 July 2017 • Accepted: 21 July 2017

Abstract

Purpose
Hand fractures can be treated conservatively in many cases, but rotation malalignment is one of the important indications for surgical treatment because of dysfunction. We performed open reduction and internal fixation in these malalignment fractures and report clinical and radiological results.

Methods
This study included 28 patients (18 male, 10 female) who had metacarpal and phalangeal fractures with rotational malalignment of finger on initial examination. Patients with combined injuries including open soft tissue damage or multiple fractures were excluded. Mean age was 36.1 years and average follow-up period was 14.6 months. Perioperative extent of rotation and correction during the follow-up, union on the radiographs, Range of motion, disability of the arm, shoulder and hand (DASH) score, and pinch power at the last follow-up were evaluated.

Results
Average corrected angulation of rotation was 11.9° and no patient showed scissoring appearance of fingers at the last follow-up. All patients showed solid bony union on the radiographs during the follow-up. The average of total active motion of the injured fingers were average 254°, average DASH score was 3.2 and average pinch power was 3.0 kg at the last follow-up.

Conclusion
Clinical and radiologically satisfactory results were obtained in all patients. Care should be taken not to overlook the rotational misalignment after fracture of the hand, and surgical treatment should be considered to ensure correct reduction and fixation.

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