Osteosynthesis for the unstable fracture of the hand.

Unstable, displaced, fractures of the hand present a challenge to surgeons all over the world. Retention of the reduction using a cast, splint or even K wire fixation is difficult during the period of bone healing: also a relatively prolonged period of immobilisation after such treatment leads to stiffness of the metacarpal and finger joints. The picture gets more complicated if the hand suffers more than one fracture. The unique ability of the hand to grasp and grip objects of different size and shape depends on the intact functional anatomy of the hand articulations. Thus accurate and stable reduction of metacarpal and phalangeal fractures is essential for early active mobility with a view to early return to work even before the recovery is complete, especially in the case of an industrial worker. We recommend osteosynthesis as a method of choice for treating such displaced, unstable fractures of the hand as shown by the present retrospective study of fifty patients. We suggest a simple practical method of assessing the results of treatment for severe fractures of the hand.