Open reduction and internal fixation of isolated 4th metacarpal shaft fracture in recreation athletes: single center results

Background: Metacarpal fractures are common injuries, which appear in the general population, as well as in the population of athletes. Aim: The aim of this retrospective study was to show a twofold series of isolated 4th metacarpal shaft fractures exclusively in the population of recreation athletes, which were surgically treated and the time frame of their return to everyday activities according to applied measures of treatment and postoperative care. Study design: Retrospective observational study. Methods: A retrospective single center study was conducted, including 49 patients (37 male, 12 female), mean age 25.7, with isolated 4 th metacarpal shaft fracture, which occurred during the two-year period from January 2010 to December 2011. Inclusion criteria were: isolated dislocated 4 th metacarpal shaft fracture, acute injury with onset no longer than 10 days before being admitted to hospital, recreation athletes and participants younger than 40 years of age. Injury mechanisms were direct contact or punch (26), fall (14) and rotational motion of the hand (9). Patients were surgically treated with internal fixation with low profile plates (20) or with 2 or 3 (29) mini-screws. Patients followed protocol for one-day surgery and afterwards standard rehabilitation protocol with early mobilization. Results: The mean follow-up of the patients was 12 months. Average total value of postoperative MCP flexion was 54.7 degrees and MCP extension was 8.97 degrees and total value of postrehabilitational MCP flexion was 88.97 degrees and MCP extension 17.04 degrees. No complications were noted, all fractures healed, without any signs of infection or malunion. Conclusion: Surgical treatment of the 4 th metacarpal shaft fracture with low profile plates and miniscrews is a good technique that represents rigid fixation and provides fast recovery to pre-injury range of movements. The quality of life is enhanced due to fast recovery and return to normal daily and sports activities. Such treatment indicates profitability, hence to a one-day surgery, decreasing treatment costs and resulting in high beneficial aspects for patients.