Metacarpal fractures

We have treated 1,080 fractured metacarpals between January 1972 and December 1982. Supported by ten years of experience and this homogenous series, we explain our choices of treatment. With early mobilization of hand and fingers a constant preoccupation to prevent joint stiffening, two main points stand out: active immediate mobilization, considered not as a dismissal but as a treatment, is managed by a specialized physiotherapist and supervised by the surgeon. We applied it in 32% of our cases. Internal fixation is sometimes tricky and always done with great attention to detail. If so, it enables quick recovery of normal amplitudes of movement through the active mobilization allowed by a stabilized fracture. This is what we did in 47% of our cases, using either plates and/or screws, or fine Kirschner wires following G. Foucher's technique. The other techniques used in 21% of our cases are reviewed along with the complications we came across while treating these fractures. The final data review of this series shows 93.2% god or very good, 4.7% fair and 2% poor results.