The objective of this study was to evaluate the clinical results of internal fixation using plates and screws or screws only for the treatment of unstable metacarpal fractures.

We retrospectively reviewed the clinical and radiologic records of 21 patients with 23 metacarpal fractures treated by open reduction and internal fixation with plates and screws or with screws only from Nov. 1999 to Sep. 2001. 1.5 mm plates and screws were used in 9 cases, 1.7 mm plates and screws in 6 cases and 2.0 mm plates and screws in 7 cases; a 2.7 mm plate and screw was used in one patient with a large metacarpal. The average follow-up period was 15 months. To assess the results, the range of motion, complications and radiographic findings were investigated.

The mean period of bone union was 8.5 weeks. Most patients had regained a full range of motion at last follow-up and there was no evidence of rotational deformity or shortening. Complications were plate breakage in 1 case, delayed union in 1 case and dorsal angulation in 3 cases.

Internal fixation using plates and screws is considered to be a useful method of providing anatomical reduction, and to allow early motion in the treatment of unstable metacarpal fractures.