Surgical Management of Metacarpal Fractures by a General Surgeon in Rural Australia: A Single-Centre Experience.

OBJECTIVE

Metacarpal fractures are common injuries which can result in significant loss of function. While many metacarpal fractures can be treated nonoperatively, surgical management options include the use of Kirschner wires, plates and screws (1, 2). In Australia, metacarpal fractures are usually managed by specialised Plastic or Orthopaedic surgeons. Provision of plastic and orthopaedic surgery in rural and remote Australia is often limited. Management of metacarpal fractures by general surgeons, who are more widespread throughout rural Australia, is not described in the literature. This study describes the demographics, surgical techniques and outcomes of metacarpal fractures managed by a rural general surgeon in rural Western Australia.

METHODS

Retrospective cohort study.

DESIGN

Observational.

SETTING

Single-centre public hospital in rural Western Australia.

PARTICIPANTS

All patients who underwent surgical management of metacarpal fractures from 2018 to 2023 at the study hospital.

MAIN OUTCOME MEASURES: Demographics, mechanism of injury, surgical techniques and outcomes of surgically managed metacarpal fractures.

RESULTS

In total, 68 cases of surgically managed metacarpal fractures are described, including 42 open and 25 percutaneous fixations. Mean time to surgery from injury was 7.3 days (median 4 days). Documented nonunion or malunion occurred in 3% of cases. In total, seven cases required unplanned return to theatre, and four cases experienced postoperative infection within 30 days.

CONCLUSIONS

Metacarpal fractures can be safely managed by an appropriately trained general surgeon in rural Australia, ensuring patient-centred, timely and effective treatment with excellent clinical outcomes.