Influence of fracture pattern on consolidation after metacarpal plate fixation.

INTRODUCTION

Consolidation problems may complicate plate fixation of metacarpal fractures. It was our clinical impression that the fracture's morphology and the patient's occupation may influence this complication.

METHOD: Retrospective study on 104 extra-articular metacarpal fractures. Time to union, presence of consolidation problems and time to return to work were correlated with fracture pattern (transverse/non-transverse), presence of soft tissue injury, type of patients and type of plate.

RESULTS

Twelve patients (15%) experienced consolidations problems: 8 patients within the transverse fracture pattern group (29.6%) and 4 patients (7.4%) within the non-transverse fracture group. The difference was significant (P = 0.01). Manual workers were found to be more likely than non-manual workers to have consolidation problems (p < 0.01) in both groups of fractures. There was no correlation between consolidation problems and hand dominance (P = 0.76), soft tissue injury (P = 0.24) or type of plate (P = 0.34).

DISCUSSION: We found a significant correlation between fracture patterns, patients' profession and consolidation problems. Despite technical advances in plate design, management of such fractures by plating remains fraught with complications, demands meticulous handling of soft tissue and does not allow for technical error.