Reliability of unicortical plate fixation for metacarpal shaft fractures: A preliminary clinical report with short-term follow-up.

Abstract

Background: Unicortical plate fixation offers several theoretical advantages in the treatment of metacarpal shaft fractures compared to bicortical fixation. This approach avoids the potential hazard of excessive drilling into the volar cortex, thus minimizing damage to surrounding soft tissues and helping prevent complications related to improperly sized screws. These benefits prompted our team to conduct a preliminary clinical study to investigate the effectiveness and safety of this approach. In this study, we present our initial experience assessing the efficacy of utilizing unicortical plate fixation for treating metacarpal shaft fractures.

Methods: A retrospective study was conducted on patients who presented with transverse or short oblique displaced metacarpal shaft fractures and who underwent surgical intervention using unicortical plate fixation. The primary outcome measures assessed the union rate and total active motion (TAM), and the secondary outcomes included evaluations using the quick Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH), as well as complication rates.

Results: Thirteen patients with a median age of 35.2 years were included in this study. All patients in the study were followed for six months. All fractures achieved successful union (100%) in all patients, and the average TAM of the respective digit was 257.7° during the final follow-up period. The mean quick DASH score was 16.83±18.1 at the 6-month follow-up. There were no cases of implant failure in our series; however, one patient (7.69%) had a rotational deformity that necessitated corrective surgery.

Conclusion: Unicortical plating fixation is a safe and reliable alternative to the standard bicortical plating method for metacarpal shaft fractures. It offers comparable union rates and satisfactory outcomes.

Level of evidence: IV/therapeutic.