Complications and range of motion following plate fixation of metacarpal and phalangeal fractures.
Eighty-two patients with 105 metacarpal and/or phalangeal fractures stabilized with plates were retrospectively reviewed to assess complications and outcomes. Despite stable fixation and early mobilization, major complications were encountered in 36% of fractures, especially with phalangeal and open fractures. Complications included stiffness, nonunion, plate prominence, infection, and tendon rupture. Forty-eight of 63 (76%) metacarpal fractures and 44 of 66 (67%) closed fractures had a final range of motion greater than 220 degrees; however, only 4 of 37 (11%) phalangeal fractures and 8 of 34 (24%) open fractures achieved this outcome. Despite technical advances in plate design and instrumentation, including lower-profile titanium plates, complications occur commonly with metacarpal and phalangeal fractures, leading to a high incidence of unsatisfactory results. We do not condemn plate fixation, and attribute many of our unsatisfactory results to the frequent use of plates in open and phalangeal fractures.
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S M
SM
Department of Orthopedic Surgery, University of Cincinnati College of Medicine and Cincinnati Hand Surgery Specialists, OH 45206, USA.
Stern
P J
PJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates / Q000009:adverse effects*; D005260:Female; D005383:Finger Injuries / Q000601:surgery; D005592:Fracture Fixation / Q000009:adverse effects* / Q000295:instrumentation; D050723:Fractures, Bone / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008662:Metacarpophalangeal Joint / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D011379:Prognosis; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012307:Risk Factors