title: Comparison of the intramedullary nail and low-profile plate for unstable metacarpal neck fractures.
abstract: BACKGROUND
  There is no robust evidence for the best treatment practice for metacarpal neck fractures. The purpose of this comparative study was to investigate whether the intramedullary nail or low-profile plate allows for good clinical and radiological results for displaced metacarpal neck fractures.
  
  
  METHODS
  We prospectively reviewed 30 patients with a displaced metacarpal neck fracture who underwent surgery: 15 with intramedullary nails and 15 with low-profile plates. Radiographic and clinical outcomes of both groups were compared. Objective findings of range of finger motion and grip strength were assessed at 3, 6, and 12 months postoperatively.
  
  
  RESULTS
  There was no non-union, and postoperative complications included extensor tendon rupture in one and transient ulnar nerve neuritis in two. Radiological parameters after the fracture healing were comparable between the two groups. Postoperative range of finger motion was better in patients with the intramedullary nail, and acquired grip strength in the low-profile plate group was superior to that in the intramedullary nail group.
  
  
  CONCLUSIONS
  The current results indicate that both procedures are highly effective in maintaining fracture restorations. Plate fixation provides earlier recovery of powerful hand function, and intramedullary nailing allows a wide range of finger motion.
authors.affiliation: Department of Orthopedics, Ishinkai-Yao General Hospital, 1-41 Numa, Yao, Osaka 581-0036, Japan.
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Fujitani
authors.forename: Shohei
authors.initials: S
authors.lastname: Omokawa
authors.forename: Koji
authors.initials: K
authors.lastname: Shigematsu
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000293:injuries* / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016059:Range of Motion, Articular; D016896:Treatment Outcome