title: [Analysis and prevention of the complications after treatment of metacarpal and phalangeal fractures with internal fixation].
abstract: OBJECTIVE
  To retrospective analysis the complications after treatment of metacarpal and phalangeal fractures with internal fixation, and propose measures to prevent or reduce surgical complications.
  
  
  METHODS
  From July 2007 to October 2009, 342 patients with metacarpal and phalangeal fractures were treated with internal fixation,including 203 males and 139 females with an average age of 30.4 years old ranging from 18 to 56 years. There were 217 right hands and 125 left hands, 38 cases of the first metacarpal fracture, 47 cases of the second metacarpal fracture, 52 cases of the third metacarpal fracture, 40 cases of the forth metacarpal fracture, 39 cases of the fifth metacarpal fracture, 43 cases of the proximal phalangeal fractures, 52 cases of the middle phalangeal fractures, and 48 case of the distal phalangeal fractures. The fractures were fixed with K-wires in 129 patients, mini plates in 153 cases, screws in 48 cases, wires in 12 cases.
  
  
  RESULTS
  All 324 patients were followed up for 3 to 15 months (averaged 8.5 months) and complications occurred in 74 patients (22.84%). The main complication was unhealthy wound healing in 24 patients (7.4%), others was adhesion of tendon in 54 patients (16.67%), malunion in 34 patients (10.49%), nonunion in 13 patients (4.01%) and shortening of metacarpal and phalangeal in 21 patients (7.41%).
  
  
  CONCLUSIONS
  The important reasons responsible for complications are iatrogenic factors such as unsuitable implant selection, unskillful surgical technique and improper post-operative functional rehabilitation.
authors.affiliation: Department of Hand Surgery, the Second Hospital of Zhenhai, Ningbo, Zhejiang, China. yanyuming2003@163.com
authors.forename: Yu-ming
authors.initials: YM
authors.lastname: Yan
authors.forename: Wei-ping
authors.initials: WP
authors.lastname: Zhang
authors.forename: Yong
authors.initials: Y
authors.lastname: Liao
authors.forename: Ze-fu
authors.initials: ZF
authors.lastname: Weng
authors.forename: Wei-jie
authors.initials: WJ
authors.lastname: Ren
authors.forename: Jun
authors.initials: J
authors.lastname: Lin
authors.forename: Xian-ao
authors.initials: XA
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D050278:Finger Phalanges / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D020127:Recovery of Function; D014057:Tomography, X-Ray Computed; D055815:Young Adult