Fractures of the phalanges and metacarpals are the most common fractures of the upper limb and account for 10% of all fractures. Along with fractures of the carpal bones, they represent 55% of upper extremity fractures. Although over the last few decades there has been an increased tendency to treat hand fractures with internal fixation, the vast majority of these fractures are stable and can (and should) be treated non-operatively. If surgical fixation is considered, then it must be appreciated that some hand fractures, particularly those affecting the proximal phalangeal shaft and intra-articular fractures, can be unforgiving. Fractures treated poorly, using inappropriate equipment in inexperienced hands can lead to irretrievably poor outcomes. Good or perfect results can be obtained with surgical fixation, but these demand careful planning with consideration of all the various methods in the surgical repertoire. The best, and possibly the only opportunity to obtain a good result is at the first surgical intervention and so those fractures requiring fixation should not be treated by unsupervised inexperienced surgeons. It is preferable to delay fixation by a few days until the best expertise is available.
Outcome of Internal Fixation of Metacarpal Fractures of Hand at a Tertiary Care Hospital, Kathmandu
