title: Ten years stable internal fixation of metacarpal and phalangeal hand fractures-risk factor and outcome analysis show no increase of complications in the treatment of open compared with closed fractures.
abstract: BACKGROUND
  : Stable internal screw/plating systems for hand fractures have evolved during the last 20 years. The improved versatility leads to the increased use of these materials in open fractures, with the benefit of early mobilization. The aim of this retrospective study is to discern whether the broadening of the indications for these implants is accompanied by increased complication rates.
  
  
  METHODS
  : Data from 365 patients treated during the last 10 years at our department for metacarpal or phalangeal fractures with stable internal fixation by screw or plate were gathered and analyzed.
  
  
  RESULTS
  : Uneventful bony consolidation was observed in 91.2% (n = 333). The functional results were excellent to acceptable in 85.2%, whereas in 14.8% (n = 54), the result was unsatisfactory, the latter group presenting with concominant soft tissue injury. There was no statistically significant difference in infection and nonunion rates when comparing open and closed fractures.
  
  
  CONCLUSIONS
  : These results confirm that most patients with open metacarpal and phalangeal fractures can be treated by stable internal fixation.
authors.affiliation: Departments of Plastic and Hand Surgery, University of Freiburg Medical Center, Freiburg, Germany. holger.bannasch@uniklinik-freiburg.de
authors.forename: Holger
authors.initials: H
authors.lastname: Bannasch
authors.forename: Anne K
authors.initials: AK
authors.lastname: Heermann
authors.forename: Niklas
authors.initials: N
authors.lastname: Iblher
authors.forename: Arash
authors.initials: A
authors.lastname: Momeni
authors.forename: Jürgen
authors.initials: J
authors.lastname: Schulte-Mönting
authors.forename: G Bjoern
authors.initials: GB
authors.lastname: Stark
mesh_terms: D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D015331:Cohort Studies; D005260:Female; D050278:Finger Phalanges / Q000293:injuries*; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D005596:Fractures, Closed / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000293:injuries*; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult