Management of Compound Metatarsal Fractures under Tamil Nadu Accident and Emergency Care Initiative

Abstract

Ab s t r Ac t Introduction: Metatarsal fractures are common among foot injuries. This study aimed to evaluate and analyze the functional outcomes of compound metatarsal fractures using the anterograde retrograde fixation technique under the Tamil Nadu Accident and Emergency Care Initiative. Materials and methods: This is a prospective study done on patients admitted with compound metatarsal fractures in emergency orthopedic unit, Government Coimbatore Medical Hospital under Tamil Nadu Accident and Emergency Care Initiative between January 2020 and December 2020. The displaced compound metatarsal fractures are treated with limited internal fixation using Kirschner’s wires within the golden period of 6 hours and they were covered under Government of Tamil Nadu Chief Minister’s Comprehensive Health Insurance Scheme–Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (TNCMCHIS-AB-PMJAY). Anterograde retrograde technique was used for the fixation of compound metatarsal fractures. Results: The American Orthopaedic Foot and Ankle Society score was used to assess the functional outcome of compound metatarsal fractures. Good results were observed in 32 patients and excellent results were observed in 5 patients. Fair results were seen in three patients. Conclusion: The compound undisplaced metatarsal fractures can be treated conservatively. The displaced metatarsal fractures need limited internal fixation with Kirschner’s wires. The Tamil Nadu accident and emergency care initiative provide early treatment and early discharge of the patients. The health department is no more an expenditure department for the government since it generates money from TNCMCHIS– AB-PMJAY which is very useful for the patients from below poverty line.