PROSPECTIVE STUDY OF FUNCTIONAL OUTCOME OF FRACTURE FIXATION OF METACARPAL BY MULTIPLE INTRAMEDULLARY PINS

Dr. Ashok Vidyarthi, Dr. Brajesh Dadarya and Dr. Ajay Dhanopeya*

ABSTRACT

Aim: The aim was to study the functional outcome of metacarpal shaft fracture treated with intramedullary fixation of pins. Methods: A nonrandomized, uncontrolled prospective study was performed on 38 patients with 58 metacarpal fractures were treated with intramedullary pinning. All patient were screened using inclusion and exclusion criteria and those, willing to participate in the study was included and were followed up prospectively at the time of discharge, at 4 weeks, at 6 weeks, at 8 weeks, and 12 weeks and assess the Hand x ray-AP/Oblique, Total active movement, Grip strength, VAS score Final results were noted according to the % TAM score for 2nd to 5th metacarpals Results:Male patients had a significantly higher frequency (84.2%) in comparision to female patients (15.8%)Most common ray affected was 4th and 5th ray followed by 2nd ray and then third ray.45% of fractures were oblique type and 41% fractures were transverse with spiral and comminuted being 12% and 2% respectively.shaft of metacarpal fracture was maximum affected (50%) followed by base (18.4%) and neck (15.8%) and head (15.8%).50% patients underwent implant removal in a period of 6 weeks.Mean – 6.89 ± 1.15weeks (min. 5weeks, max. 10weeks).42.1% patients of metacarpal fracture had radiological union in 6 weeks.Mean time to union 6.21±1.094 (min. 4weeks, max. 8weeks).Mean grip strength at final follow up was 24.55 ± 8.366 (min 10 and max 50) for affected hand, whereas mean grip strength at normal hand was 36.03 ± 10.476.Mean pre-op VAS pain score 6.53 ± 1.202 (min 4 and max 8) and mean VAS pain score at 8 weeks follow up is 1.42 ± 1.681 (min 0 and max 4).

Keywords: VAS Score, Intramedullary Pinning, Metacarpal Fracture.