Plate fixation with a single incisional approach in adjoining two metacarpal shaft fractures

Purpose: Multiple metacarpal shaft fractures are higher-energy injuries than single metacarpal shaft injuries and are considered relatively unstable because reduction is easily lost after splinting. However, few studies have been published on operative treatment because these fractures are rare. The aim of this study was to analyze the characteristics of this rare type of fracture and report the surgical outcomes.Methods: Medical records of patients with adjacent metacarpal shaft fractures who underwent surgery were retrospectively analyzed. In total, 20 cases were included in this study. A single longitudinal incision was made at the middle of the web space of affected metacarpal bones. Fractures were fixed using a plate and screws. The clinical results were evaluated by determining the metacarpophalangeal joint range of motion, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and hand grip strength at the final follow-up. Results: Among the patients included, there were 15 male and five female patients. Their mean age was 41.2 years. The average range of motion of metacarpophalangeal joints was 78.1°. The average DASH score was 6.5. The average hand grip strength was 92.4% compared to the unaffected side. The mean time to union was 7.5 weeks. There were no cases of complications, such as soft tissue infections, joint stiffness, or extensor tendon injuries.Conclusion: Plate fixation through a single incisional approach performed for adjacent metacarpal shaft fractures showed satisfactory results. This could be a recommendable approach for two unstable adjoining metacarpal shaft fractures.