Metacarpal Fracture Fixation
Project
Protocol for metacarpal transverse fractures(breaking hand bone in half) is to secure a plate with three screws above and three below the break. However bones within the hand are so small drilling six screw holes causes significant damage, and may not be necessary.
This project aims to determine if 4 screws are sufficient to securely fix a metacarpal transverse fracture.
Contribution
I joined the project to continue fixing the bones with plates and screws, carry out testing, and possibly improve the protocol to create a more standard procedure.
On the right is the initial device to secure the bones during plating. Note the device fails to prevent against lateral and rotational motion leading to numerous lost specimens.
The bones were initially systematically broken with a wood cutting Dremel bit causing cuts to be significantly skewed and inconsistent.
Solution
After understanding that the rotational and lateral axis' of the bones needed to be secured during plating we looked for a method preventing lateral, rotational, and longitudinal motion.
We designed a silicone mold which could repeatedly be used to form a resin frame to prevent motion along all axis'.
Conclusion
After designing a resin mold which prevented motion along all axis', not a single bone was rendered unusable due to plating errors.
With a reliable protocol in place, testing is ongoing to determine if a plate with 4 screws provides the same stability and strength as one with 6.
Results
Testing concluded showing no significant difference between metacarpals fixed with four screws vs. six screws.
The manuscript has been published in the HAND journal.