Treatment of open metacarpal fractures with supercutaneous locking plate

Objective To evaluate the supercutaneous fixation with locking plate for treatment of open metacarpal fractures. Methods From March 2015 to November 2016, 16 open metacarpal fractures were treated with supercutaneous locking plate after emergency debridement at Department of Hand Surgery, The Second Affiliated Hospital to Wenzhou Medical University. They were 11 men and 5 women, from 20 to 67 years of age (average, 37.5 years). There were 2 cases of the 1st metacarpal fracture, 6 ones of the 2ed metacarpal fracture, one of the 3rd metacarpal fracture, 2 ones of the 4th metacarpal fracture and 5 ones of the 5th metacarpal fracture. All fractures were open injury. By the Gustilo-Anderson classification, there were 9 cases of type Ⅱ and 7 ones of type ⅢA. Functional rehabilitation was encouraged immediately after operation. The out-comes were evaluated at the 4th and 24th weeks postoperatively according to the Total Angle of Motion (TAM) for digital joints recommended by the Hand Surgery Society, Chinese Medical Association. Results The mean operation time was 46.8 minutes (from 35 to 108 minutes). All cases were followed up for an average of 9.8 months (from 7 to 25 months). All fractures healed without breakage or loosening of the supercutaneous locking plate after an average of 6.2 weeks(from 4.3 to 7.8 weeks). Nail tract infection occurred in 3 cases. According to the TAM at the 4th week postoperatively, 5 cases were rated as excellent, 8 as good, 2 as fair and one as poor; according to the TAM at the 24th week postoperatively, 11 cases were rated as excellent, 4 as good and one as fair. Conclusion For open metacarpal fractures with severe contamination or soft tissue injury, supercutaneous locking plate fixation can achieve fine clinical outcomes. Key words: Metacarpal bones; Fractures, open; Bone plates; Fracture fixation