Complications of plate fixation in metacarpal fractures.
BACKGROUND
The objective of this study is to assess the complications after open reduction and plate fixation of extra-articular metacarpal fractures.


METHODS
We retrospectively reviewed the clinical and radiologic records of 129 consecutive patients with 157 metacarpal fractures treated by open reduction and internal fixation with plates between 1993 and 1999. Intra-articular fractures and fractures of the thumb metacarpal were excluded. Eighty-one patients (64 men and 17 women) with 104 fractures were available for review, at an average follow-up of 13.6 months (range, 6-27 months).


RESULTS
Twenty-eight patients (35%) and 33 fractures (32%) had one or more complications, including difficulty with fracture healing (12 patients [15%]), stiffness (eight patients [10%]), plate loosening or breakage (seven patients [8%]), complex regional pain syndrome (two patients), and one patient who developed a deep infection.


CONCLUSIONS
Despite technical advances in implant material, design, and instrumentation, plate fixation of metacarpal fractures remains fraught with complications and unsatisfactory results.
Fusetti
Cesare
C
Hand Surgery Unit, Division for Reconstructive Surgery, University Hospital of Geneva, Geneva, Switzerland.
Meyer
Henning
H
Borisch
Nicola
N
Stern
Richard
R
Santa
Dominique Della
DD
Papaloïzos
Michael
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D016009:Chi-Square Distribution; D005260:Female; D005592:Fracture Fixation / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000293:injuries*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology