Treatment of metaepiphyseal fractures of the metacarpal bones

Background: Hand injuries are an urgent medical problem, since they can lead to a long-term loss of general working capacity (in about 30% of patients), loss of professional working capacity of patients whose work activity is associated with loads on the brush (workers in the manufacturing sector, athletes, musicians, and other professions), a decrease in the quality of life and household activity. The wide prevalence and data on the steady increase in the frequency and severity of metacarpal fractures further confi m the need for an in-depth study of the problem of metacarpal fractures.Th purpose of this article: To analyze the data of the world literature on the treatment of patients with fractures of the metacarpal bones of the hand. Material and methods: The sources of foreign and domestic literature for the last 8 years were used. The selection of sources was carried out according to the keywords: metacarpal fracture, multi-comminuted and comminuted fracture of the metacarpal bone of the hand, metacarpal bone osteosynthesis, intramedullary metacarpal bone osteosynthesis. Results: The standard treatment of patients with fractures of the metacarpal bones is extramedullary osteosynthesis, for multi-splintered fractures of the metacarpal bones, spoke osteosynthesis is used. However, these methods of treating patients with metacarpal fractures have their drawbacks, such as postoperative contracture, an increased risk of infectious complications, delayed fusion of the metacarpal bones, migration of metal fi ers, the inability to reliably fi the fracture in comminuted fractures, postoperative neuropathy, cosmetic defect and a number of others. Discussion: An analysis of the literature has shown that the most accurate bone fragment reposition, as well as a differentiated algorithm for treating patients with metacarpal fractures using minimally invasive techniques, can reduce the time of fusion and improve treatment results. There is also no reasonable algorithm for the rational choice of tactics for surgical treatment of patients with comminuted and multi-comminuted fractures of the metacarpal bones of the hand. Conclusion: A frequent complication of fractures of the bones of the hand is the formation of stiffness in the metacarpal and metacarpophalangeal joints, the development of which is associated with prolonged immobilization. The analysis of the literature data showed that there is no strict algorithm for the treatment of patients with metacarpal fractures, standard treatment does not always allow achieving a good treatment result, and the high frequency of complications pushes for the study.