The Results of Miniplate Fixation for the Fractures of Metacarpal and Phalangeal Bones of the Hand / 대한정형외과학회잡지

Fracture healing in the hand is not an isolated goal. The functional end result is of paramount importance. When the correct techniques are used, miniplate fixation for metacarpal and phalangeal fractures of the hand provides rigid internal fixation, stabilizes the skeleton, preserves the gliding tissue, and therefore allowing immediate active range of motion exercise as well as minimizing joint and tendon complications. The authors have reviewed 39 patients, 52 cases of metacarpal and phalangeal fractures of the hand which were treated with miniplate in the department of orthopaedic surgery, Chang Ang Gil hospital from Sep. 1989 to Feb. 1993. The following results were obtained. 1. Miniplate fixation, in terms of fracture reduction and maintenance, allows on accurate anatomic reduction with rigid fixation which in turn affords on early mobilization without loss of reduction alignment. 2. The roentgenographic union was obtained within 15.1 weeks in average. The mean total acitve motion at the fractured finger was 230°. The complication rate was 11.5%. 3. In the treatment of metacarpal and phalangeal fractures of the hand, especially fractures of metacarpal bones, fixation with miniplate is considered to be an useful method in terms of getting fracture union and good range of motion with relative low complication rates.

Operative Treatment in Fractures of the Metacarpal and Phalanx in the Crushing Injury / 대한정형외과학회잡지

Fractures of the metacarpal and phalanx of the hand are common occurances and bony union usually occurs without difficulties. If complication of the metacarpal and phalangeal fracture of the hand occurred, it causes significant functional deficit. The authors have reviewed 92 patients, 121 cases of metacarpal and palangeal fracture of the crushed hand which were treated with internal fixation with/without open reduction in the deparment of orthopaedic surgery in Holy Family Hospital from Jan. 1985 to Dec. 1989. The authors obtained the following results ; 1. The incidence of nonunion and delayed union was 12.4% (15/121 cases). 2. The criteriae of nonunion and delayed union are progressive angulation at fracture site after removal of implant, lack of bony union evidence in the radiography more than 12 weeks after injury, tenderness and pain on motion at fracture site and gross pseudomotion. 3. Nonunion and delayed union occurred more commonly in phalangeal fractures, shaft fractures, severely traumatized fractures (open fractures, marked displaced fractures, comminuted fractures and fractures had associated injuries in the same hand) and under-reduced fractures after internal fixation. 4. Mean TAM (total active motion) range at last follow up was 94.5°in thumb and 186.6°in finger and that of nonunion and delayed union cases was 89°in thumb and 153.5°in finger.