Phalangeal fractures treated with osteosynthesis plates. Short - term results.
Abstract
IntroductionA prospective cohort study was carried out to evaluate functional results in workers with phalangeal fractures treated with plates and to establish poor prognostic factors.MethodsFrom May 2012 to May 2014, 55 workers with phalangeal fractures were operated on consecutively by reduction and fixation with plate and screws. Forty-two patients (39 men; average age 30.76 years) were evaluated, with 68 operated phalanges (first phalanx 15, second phalanx 53). Twenty-eight percent of fractures were open, 38.24% comminuted and 11.76% had joint involvement. Average follow-up: 3.38 months.ResultsBone union was achieved in all fractures in 1.8 months. Gingrass score for the thumb was good in two cases and regular in one. In the remaining fingers, Belsky score was excellent (35%), good (55%), and poor (9%). Average DASH score was 18.53. Worst results were observed in the first phalanx fractures with respect to the second and in older patients than in the younger, both with statistical significance. No relationship was observed between the outcome and other variables studied. Four patients had complications (9.5%).ConclusionsComparing our study with others, the rate of complications was small, and similar results were obtained, but unlike other authors, we are not used to remove hardware with tenolysis or arthrolysis. Bone union was achieved in all cases and results were satisfactory in 90% of patients.Downloads
References
Emmett JE, Breck LW.A review and analysis of 11,000 fractures seen in a private practice of orthopaedic surgery, 1937-1956. J Bone Joint Surg Am 1958;40:1169-75.
Barton N. Conservative treatment of articular fractures in the hand. J Hand Surg Am 1989;14:386-90.
Lu WW, Furumachi K, Ip WY, Chow SP. Fixation for comminuted phalangeal fractures: a biomechanical study of five methods.
J Hand Surg Br 1996;21:765-7.
Kurzen P, Fusetti C, Bonaccio M, Nagy L. Complications after plate fixation of phalangeal fractures. J Trauma 2006;60:841-3.
Page SM, Stern PJ. Complications and range of motion following plate fixation of metacarpal and phalangeal fractures. J Hand
Surg Am 1998;23:827-32.
Gustillo RB, Mendoza RM, Williams DN. Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. J Trauma 1984;24:742-6.
Gingrass R, Fehring H, Matloub H. Intraosseous wiring of complex hand fractures. Plast Reconstr Surg1980;66:383-94.
Belsky M, Eaton R, Lane L. Closed reduction and internal fixation of proximal phalangeal fractures. J Hand Surg Am 1984;9:725-9.
Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm,
shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 1996;29:602-8.
Agarwal AK, Pickford MA. Experience with a new ultralow-profile osteosynthesis system for fractures of the metacarpals and phalanges. Ann Plast Surg 2006;57:206-12.
Meckel S, Voigt M, Van Hüllen C, Horch R, Stark GB. Experiences with rigid internal fixation using a low volume titanium implant system in metacarpal and phalangeal fractures. Eur J Plast Surg 2000;23:16-20.
Omokawa S, Fujitani R, Dohi Y, Okawa T, Yajima H. Prospective outcomes of comminuted periarticular metacarpal and phalangeal fractures treated using a titanium plate system. J Hand Surg Am 2008;33:857-63.
Bosscha K, Snellen JP. Internal fixation of metacarpal and phalangeal fractures with AO minifragment screws and plates: a prospective study. Injury1993;24:166-8.
Hastings H. Unstable metacarpal and phalangeal fracture treatment with screws and plates. Clin Orthop1987;214:37-52.
Pun WK, Chow P, So YC. Unstable phalangeal fractures: treatment by A.0. screw and plate fixation. J Hand Surg Am 1991;
:113-7.
Shimizu T, Omokawaa S, Akahane M, Murata K, Nakano K, Kawamura K, et al. Predictors of the postoperative range of finger
motion for comminuted periarticular metacarpal and phalangeal fractures treated with a titanium plate. Injury 2012;43:940-5.
Barton N. Fractures of the phalanges of the hand. The Hand 1977;9:1-10.
Singh J, Jain K, Mruthyunjaya, Ravishankar R. Outcome of closed proximal phalangeal fractures of the hand. Indian J Orthop 2011;45(5):432-8.
Stanton JS, Dias JJ, Burke FD. Fractures of the tubular bones of the hand. J Hand Surg 2007;32:626-36.
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