gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Volar plating of 5th metacarpal neck fractures

Meeting Abstract

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  • presenting/speaker Maria Downey - Centre for Hand And Reconstructive MicroSurgery, Singapore, Singapore
  • Beng Hai Lim - Centre for Hand And Reconstructive MicroSurgery, Singapore, Singapore
  • May Fong Chan - Department of Hand & Reconstructive Microsurgery, National University Hospital (S) Pte Ltd, Hand & Reconstructive Microsurgery Cluster, Singapore, Singapore
  • Aaron Gan - Centre for Hand And Reconstructive MicroSurgery, Singapore, Singapore

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSHT19-1079

doi: 10.3205/19ifssh1493, urn:nbn:de:0183-19ifssh14930

Published: February 6, 2020

© 2020 Downey et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: To evaluate the outcomes following volar plating for 5th metacarpal fractures.

Materials and Methods: Fracture of the 5th metacarpal neck is one of the most common presentations of hand injuries. Dorsally-placed locking plates is typically a treatment of choice. However, dorsal plating often results in loss of full flexion at the metacarpophalangeal joint due to extensor tendon adhesions and dorsal capsular contracture.

Volar plating of the 5th metacarpal is proposed to achieve a stable fixation without the risks of secondary displacement and loss of metacarpophalangeal joint motion due to the effects of dorsally-placed hardware.

A retrospective investigation was carried out of the medical records of patients who underwent surgical fixation of 5th metacarpal neck fracture using a volar approach. The primary clinical outcomes for this investigation were MCPJ ROM, total active motion, Quick-DASH and grip strength which were assessed at the first, six and 12-week period post-operatively.

Results: All of the functional and clinical outcomes showed continued improvement between the initial, 6 and 12-week period.

At 1-week post-op the mean Q-DASH score was 67.3 showing a clear limitation in activities of daily living, which was to be expected immediately following surgery. After completing 12 weeks of therapy, the values were significantly lower, with a mean score of 0.

Grip strength was severely reduced when compared to the contralateral side at weeks 6 post-surgery. At 12 weeks, the relative grip strength increased to 70kg.

Total active motion of the 5th digit and the range of flexion at the MCPJ was typically reduced post-operatively. The range of motion and total active motion improved by 6 weeks. After 12 weeks range of motion continued to improve with the mean MCPJ flexion reaching 84° and TAM 270°.

Conclusions: Early rehabilitation had the advantage of enabling the patients to return to early function and work. The results of the Q-DASH indicated a significant improvement in function 12 weeks post operatively.