Low-severity metacarpal and phalangeal fractures treated with miniature plates and screws. 2004

Carlo Trevisan, and Alessandro Morganti, and Alessandro Casiraghi, and Edoardo C Marinoni
Clinica Ortopedica Università degli Studi Milano Bicocca, Azienda Ospedale S.Gerardo, Via Donizetti, 106-20052 Monza, Italy. carlo.trevisan@tiscalinet.it

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.

UI MeSH Term Description Entries
D008297 Male Males
D008663 Metacarpus The region of the HAND between the WRIST and the FINGERS.
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D008904 Miniaturization The design or construction of objects greatly reduced in scale. Miniaturisation,Miniaturisations,Miniaturizations
D011182 Postoperative Care The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed) Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D001860 Bone Plates Implantable fracture fixation devices attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as bone heals. (UMDNS, 1999) Bone Plate,Plate, Bone,Plates, Bone
D001863 Bone Screws Specialized devices used in ORTHOPEDIC SURGERY to repair bone fractures. Bone Screw,Screw, Bone,Screws, Bone
D005260 Female Females
D005383 Finger Injuries General or unspecified injuries involving the fingers. Injuries, Finger,Finger Injury,Injury, Finger

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