Complications and range of motion following plate fixation of metacarpal and phalangeal fractures

Page, Steven; Stern, Peter J.

doi:10.1016/s0363-5023(98)80157-3

Cited by 328 publications

(255 citation statements)

References 13 publications

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“…However, plate fixation seems prone to high rates of stiffness, adhesions, and a higher rate of surgical re-interventions (up to 14%). These soft-tissue complications after plate fixation are observed in other studies as well [5,6]. Our findings suggest that antegrade intramedullary K-wire fixation with subcutaneous burying of K-wire ends does not bear the negative characteristics of transverse pinning nor open reduction and plate fixation.…”

Section: Discussionsupporting

confidence: 75%

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Antegrade intramedullary Kirschner-wire fixation of displaced metacarpal shaft fractures

Bussel

Houwert

Kootstra

et al. 2017

Eur J Trauma Emerg Surg

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Section: Discussionsupporting

confidence: 75%

“…Multiple studies have shown that complications are not uncommon after this technique. Complications such as infections, adhesions, and stiffness might be related to the relatively large incision [5,6].…”

Section: Introductionmentioning

confidence: 99%

Antegrade intramedullary Kirschner-wire fixation of displaced metacarpal shaft fractures

Bussel

Houwert

Kootstra

et al. 2017

Eur J Trauma Emerg Surg

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“…Although the use of metallic implants is considered the gold standard for operative treatment of displaced metacarpal fractures, these implants often are associated with high complication rates. In one series [27] that included open and closed phalangeal and metacarpal fractures, major complications were reported in 36% of patients. The most important complications were delayed union and malunion, stiffness, plate prominence, tendon irritation and rupture, infection, bony atrophy, and osteoporosis attributable to stress shielding.…”

Section: Introductionmentioning

confidence: 99%

“…Closed metacarpal fractures appear to have relatively low complication rates [26,29]. However, these complications, combined with the patient's demand for plate removal, greatly increase the probability that a second operation will be required [27].…”

Section: Introductionmentioning

confidence: 99%

Delayed Foreign-body Reaction to Absorbable Implants in Metacarpal Fracture Treatment

Givissis

Stavridis

Papagelopoulos

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background First-generation bioabsorbable implants have been associated with a high complication rate attributable to weak mechanical properties and rapid degradation. This has led to the development of stronger devices with improved durability. However, the modern implants have raised concerns about potential late-occurring adverse reactions. Questions/purposes This retrospective study addressed the following questions: Can absorbable implants consisting of trimethylene carbonate, L-lactide, and D,L-lactide provide adequate fixation for healing of a metacarpal fracture? Will these implants obviate a second removal operation? What complications can occur in the reaction to implant breakdown? Patients and Methods Twelve unstable, displaced, metacarpal fractures were studied in 10 consecutive patients (seven men, three women; mean age, 36.4 years; range, 18-75 years). The fractures were treated with absorbable plates and screws consisting of the aforementioned copolymers and designed to resorb in 2 to 4 years. Nine patients (10 fractures) were available for clinical and radiographic followups (mean, 45.7 months; range, 34-61 months).

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“…Limiting soft tissue trauma should offer improved rehabilitation potential following metacarpal fixation as long as adequate stability is achieved. Prominent hardware is another drawback of the locking plate fixation and possibly causes extensor tendon damage [18]. Although the sled may appear prominent in the porcine metacarpal model, this has more to do with the shape of porcine metacarpals and the sled has a much lower profile on human metacarpals.…”

Section: Discussionmentioning

confidence: 99%

Fixation for Metacarpal Neck Fracture: A Biomechanical Study

Malasitt

Owen

Tremblay

et al. 2015

Hand (New York, N,Y.)

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Background There is no robust evidence of the best operative treatment for displaced unstable metacarpal neck fractures. Numerous constructs are used in the fixation of metacarpal neck fractures. Currently, two common methods are dorsal locking plate and K-wire fixation. A new metacarpal sled fixation system for metacarpal neck fracture was designed to provide fracture stability but limit dissection and avoid exposed hardware. The purpose of this study was to compare the biomechanical integrity of the metacarpal sled versus standard locking plate fixation and retrograde K-wire fixation in a simulated porcine metacarpal fracture model. Methods Transverse metacarpal neck fractures were created in 30 porcine second metacarpals. The specimens were randomly fixed with locking plates, metacarpal sleds, or retrograde K-wires. Constructs were then loaded to failure in threepoint bending. Stiffness and peak load were measured from the load-to-failure deflection curve. Data were analyzed via ANOVA, followed by Tukey-Kramer's post hoc pairwise comparison. Results The K-wire group had the highest initial stiffness followed by the sled group and then the plate group. Statistical difference was only found between K-wires and plate. Peak load for the K-wire group was lowest, followed by sled, and then by plate. A statistically significant difference was observed between the peak loads of the K-wires and plate, as well as the sled and plate. However, a difference in peak load was not detected between the K-wires and sled.Conclusions For transverse metacarpal neck fractures, a metacarpal sled construct provides similar fixation to K-wires with limited dissection and without exposed hardware or the potential for soft tissue tethering. The new low profile construct using a minimally invasive technique would be suitable for unstable metacarpal neck fractures.

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Complications and range of motion following plate fixation of metacarpal and phalangeal fractures

Cited by 328 publications

References 13 publications

Antegrade intramedullary Kirschner-wire fixation of displaced metacarpal shaft fractures

Antegrade intramedullary Kirschner-wire fixation of displaced metacarpal shaft fractures

Delayed Foreign-body Reaction to Absorbable Implants in Metacarpal Fracture Treatment

Fixation for Metacarpal Neck Fracture: A Biomechanical Study

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