A case of ORIF with fibula graft of 2nd & 3rd metacarpal nonunion

Abstract

Background: The management of nonunion and malunion in the metacarpals and phalanges is one of challenging task for surgeons. The Structure has a propensity for stiffness, the ability of adjacent digits to substitute functionally for compromised digits, the small size of the bones, and associated complications. Because of atrophic changes and stiffness and tendon adhesions amputation and arthrodesis are treatment options. In our case study we have successfully treated a case of non-union of metacarpals with excellent results. Methods: A 26 years old Male presented with the chief complaint of weakness in right hand since 8 months following A/H/O crush injury. Diagnosed with 2nd, 3rd metacarpal fracture ex fix with hypogastric graft was done. Following a time period of 8 months patient presented with non-union metacarpals. Patient underwent ORIF with fibula bone grafting (Fig 4) and minifragment plate and screw fixation (Fig 5). Results: Post-operative 4 weeks following the surgery the K-wires were removed and patient was called for regular follow up and rehabilitation in the form of grip strengthening exercises. 8 weeks post-op there was a significant improvement in the ROM and hand grip, patient was given a sling and early mobilisation was started.