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J Am Acad Orthop Surg, Vol 8, No 2, March/April 2000, 111-121.
© 2000 the American Academy of Orthopaedic Surgeons
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Operative Treatment of Metacarpal and Phalangeal Shaft Fractures

Scott H. Kozin, MD, Joseph J. Thoder, MD and Glenn Lieberman, MD

Dr. Kozin is Associate Professor, Department of Orthopaedic Surgery, Temple University, Philadelphia; and Attending Hand Surgeon, Shriners Hospital for Children, Philadelphia. Dr. Thoder is Associate Professor, Department of Orthopaedic Surgery, Temple University; and Attending Hand Surgeon, Shriners Hospital for Children. Dr. Lieberman is Chief Resident, Department of Orthopaedic Surgery, Temple University.

Reprint requests: Dr. Kozin, Department of Orthopaedic Surgery, Temple University, Broad and Ontario Streets, Philadelphia, PA 19141.

Diaphyseal fractures of the metacarpals and phalanges are common injuries that can lead to impairment of hand function. The fracture pattern and soft-tissue injury vary with the mechanism of injury. The imbalance of the flexor and extensor forces created by displaced fractures will often produce a secondary angulatory deformity. Nonoperative treatment is indicated for reducible and stable fracture configurations. Irreducible or unstable fracture patterns require open or closed reduction and fixation. Reduction must be assessed in flexion and extension to ensure correct rotatory alignment. Fracture fixation can be achieved with the use of Kirschner wires, interfragmentary screws, or plates. The outcome after surgery is greatly influenced by the condition of the surrounding soft tissues; therefore, surgical trauma should be minimized to optimize the result.






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Copyright © 2000 by the American Academy of Orthopaedic Surgeons.