Title: Evaluation of AO Titanium Locking Plate and Screw Fixation for Isolated Unstable Metacarpal and Phalangeal Fractures
Authors: Dr M.Chandrashekar, Dr.M.Sudhir
Arbeitsgemeinschaft-osteosynthesefragen (AO) mini-fragment screws and plates, when used in properly selected cases, can provide rigid fixation, allowing early mobilization of joints and hence good functional results while avoiding problems associated with protruding K-wires and immobilization. This study was conducted at government medical college after getting permission from hospital ethics committee, includes 30 patients of which 20 were males and 10 were females. The average age was 30.4 years. Twenty fractures were fixed with miniature plates and 10 with interfragmentary lag screws. The right hand was involved in 22 cases. There were 15 metacarpal, 9 proximal phalangeal, and 6 middle phalangeal fractures. The distribution of the above fractures was as follows: thumb ray 7, index ray 9, middle ray 3, ring ray 6, and little ray 5. Mechanism of injury included fall(11), direct blow(3) and traffic accident(16).There were transverse(7), oblique(11), spiral(6), intraarticular(4), and 2 were comminuted. All the fractures were closed. These patients were evaluated post operatively for 3,6 months and one year. All of them presented improvement in their clinical and functional parameters regarding the variables of range of motion (ROM), visual analog scale (VAS) score, Grip strength value(%) and DASH (Disability of the Arm, Shoulder and Hand) score. All the patients achieved improved quality of life and returned to work, with significant decreases in their DASH questionnaire scores (14-2). There was an improvement in pain, with decreases in their VAS scores (2-0). This technique provides a highly rigid fixation, which is sufficient to allow early mobilization of the adjacent joints, thus helping to achieve good functional results.
Keywords: AO Screws and plates, unstable, metacarpal, phalangyeal, fracutes and fixation.