title: Low-severity metacarpal and phalangeal fractures treated with miniature plates and screws.
abstract: BACKGROUND
  The results reported in the literature of metacarpal and phalangeal fractures treated with miniature plates and screws are scarce and contradictory. The aim of our study was to evaluate the functional results after low-severity metacarpal and phalangeal fractures treated by miniature plates and screws.
  
  
  METHODS
  We retrospectively reviewed 44 patients of a consecutive series with 56 low-severity metacarpal and/or phalangeal fractures stabilized with miniature plates and screws with a mean follow-up of 24 months to assess objective and subjective outcomes and complications. The objective assessment included measurement of the range of motion (ROM) of the involved finger, prehension, sensory function and strength. The subjective evaluation assessed the impairment and pain felt by the patient.
  
  
  RESULTS
  At the final check-up, average total active movement of the involved digit was 256 degrees (range 175 degrees -260 degrees ), and average score for prehension was 49.3 (range 30-50), with 41 patients with a full score. The Jamar test pointed to a significant reduction in grip strength (-5.2%) of the injured hand compared with the other hand. Average subjective impairment score for all the fractures was 15.5 (range 10-16), with 39 patients having a score between 16 and 14 (no impairment). Fracture reduction was anatomic in 42 fractures (75%), satisfactory in 11 (19.6%) and unsatisfactory in 3 (5.4%). There were no contractures, non-unions, infections or tendon ruptures. Twenty patients (45%) presented with one or more complications in 23 fractures (41.1%).
  
  
  CONCLUSIONS
  These very favourable results suggest that miniature plates and screws are a possible choice in the treatment of these fractures.
authors.affiliation: Clinica Ortopedica Università degli Studi Milano Bicocca, Azienda Ospedale S.Gerardo, Via Donizetti, 106-20052 Monza, Italy. carlo.trevisan@tiscalinet.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Trevisan
authors.forename: Alessandro
authors.initials: A
authors.lastname: Morganti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Casiraghi
authors.forename: Edoardo C
authors.initials: EC
authors.lastname: Marinoni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D008875:Middle Aged; D008904:Miniaturization; D011182:Postoperative Care; D011859:Radiography