title: Results of surgical treatment in metacarpal shaft fractures using low profile mini plates.
abstract: BACKGROUND
  Metacarpal fractures are among the most common fractures of the hand. They may lead to loss of function if treated improperly. These injuries can be treated conservatively. However, if significant shortening, rotational deformity and angulation occur, surgical treatment is required. In this article, results of metacarpal fractures treated with open reduction and internal fixation with mini plates were presented.
  
  
  METHODS
  We retrospectively reviewed the clinical and radiologic records of twenty-nine consecutive patients with 37 metacarpal fractures treated by open reduction and internal fixation with low profile mini plate fixation between 2006 and 2013. Surgical treatment with dorsal approach was planned for cases with unacceptable shortening, rotational deformity, and angulation. Early active motion was begun in all cases postoperatively. Patients were permitted to use their hands in daily activities four weeks after surgery. For objective assessment, total range of joint motion was measured. Rotational deformity of the fingers was assessed. Grip strength and quick DASH scores were compared with the uninjured side. Metacarpal shortening was evaluated radiologically, and angulation was measured.
  
  
  RESULTS
  Mean age was 35.1 years (19-61 years) and mean follow-up period was 32 months (6-39 months). While mean operation time was 8.48 days (2-23 days), mean shortening was 7.58 (2-30) mm. In cases with radiologically documented union, mean angulation in the posteroanterior plane was 8.13 (0-42) degrees preoperatively and 3.55 (0-28) degrees postoperatively. In lateral X-rays, mean angulation was 8.22 (0-39) degrees preoperatively and 3.66 (0-28) degrees postoperatively. Mean quick DASH score was 3.6 (0-11.4). Mean grip strength measurements by Jamar hand dynamometer were 41.05 (±8.3) kg for fractured hands, 44.7 (±9) kg for normal hands. No significant relationship was found between normal hand and fracture hand by Mann-Whitney U test.
  
  
  CONCLUSIONS
  As in general fracture treatment principles, goals in metacarpal fracture treatment are obtaining an anatomical and stable reduction, fracture union and beginning early movement to avoid loss of function. Open reduction and low profile titanium plate application in metacarpal fractures is the choice of treatment in suitable cases as it meets the above mentioned treatment principles.
authors.affiliation: Department of Hand and Upper Extremity Surgery, Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey. aykutserkan@yahoo.com.
authors.forename: Serkan
authors.initials: S
authors.lastname: Aykut
authors.affiliation: Department of Hand and Upper Extremity Surgery, Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey.
authors.forename: Kahraman
authors.initials: K
authors.lastname: Öztürk
authors.affiliation: Department of Orthopedics and Traumatology, Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey.
authors.forename: Çağrı
authors.initials: Ç
authors.lastname: Özcan
authors.affiliation: Department of Hand and Upper Extremity Surgery, Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Demiroğlu
authors.affiliation: Department of Hand and Upper Extremity Surgery, Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ahmet Utku
authors.initials: AU
authors.lastname: Gürün
authors.affiliation: Department of Hand and Upper Extremity Surgery, Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Özden
mesh_terms: D000328:Adult; D001860:Bone Plates; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000293:injuries*; D008875:Middle Aged; D061646:Operative Time; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D055815:Young Adult