Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 4/2017

24.02.2017 | Handsurgery

Dorsal versus lateral plate fixation of finger proximal phalangeal fractures: a retrospective study

verfasst von: Luke P. Robinson, Michael P. Gaspar, Adam B. Strohl, Seth L. Teplitsky, Shiv D. Gandhi, Patrick M. Kane, A. Lee Osterman

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Unstable proximal phalanx fractures are relatively common injuries but consensus of standard treatment is lacking. Outcomes following plate fixation are highly variable, and it remains unclear which factors are predictive for poorer results. The purpose of this study was to compare dorsal and lateral plate fixation of finger proximal phalangeal fractures with regard to factors that influence the outcome.

Materials and methods

A retrospective chart review of proximal phalanx fractures treated with dorsal and lateral plating over a 6-year study interval was performed. Demographic data and injury-specific factors were obtained from review of clinic and therapy notes of 42 patients. Fractures were classified based on the OTA classification using preoperative radiographs. Outcomes investigated included final range of motion (ROM) and total active motion (TAM) of all finger joints. Complications and revision surgeries were also analyzed.

Results

Fracture comminution, dorsal and a lateral plate position, occupational therapy, and demographic factors did not significantly influence the outcome, complication, and revision rate after plate fixation of finger proximal phalangeal fractures.

Conclusions

Based on the results of this study, no differences in the outcome of finger proximal phalangeal fractures treated by both dorsal and lateral plate fixation were observed.

Level of evidence

Therapeutic, retrospective comparative, level III.
Literatur
1.
Zurück zum Zitat Chung KC, Spilson SV (2001) The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am 26:908–915CrossRefPubMed Chung KC, Spilson SV (2001) The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am 26:908–915CrossRefPubMed
2.
Zurück zum Zitat Feehan LM, Sheps SB (2006) Incidence and demographics of hand fractures in British Columbia, Canada: a population-based study. J Hand Surg Am 31(7):1068–1074CrossRefPubMed Feehan LM, Sheps SB (2006) Incidence and demographics of hand fractures in British Columbia, Canada: a population-based study. J Hand Surg Am 31(7):1068–1074CrossRefPubMed
3.
Zurück zum Zitat Karl JW, Olson PR, Rosenwasser MP (2015) The epidemiology of upper extremity fractures in the United States, 2009. J Orthop Trauma 29(8):e242–e244CrossRefPubMed Karl JW, Olson PR, Rosenwasser MP (2015) The epidemiology of upper extremity fractures in the United States, 2009. J Orthop Trauma 29(8):e242–e244CrossRefPubMed
4.
Zurück zum Zitat van Onselen EB, Karim RB, Hage JJ, Ritt MJ (2003) Prevalence and distribution of hand fractures. J Hand Surg Br 28(5):491–495CrossRefPubMed van Onselen EB, Karim RB, Hage JJ, Ritt MJ (2003) Prevalence and distribution of hand fractures. J Hand Surg Br 28(5):491–495CrossRefPubMed
5.
Zurück zum Zitat Figl M, Weninger P, Hofbauer M, Pezzei C, Schauer J, Leixnering M (2011) Results of dynamic treatment of fractures of the proximal phalanx of the hand. J Trauma 70(4):852–856CrossRefPubMed Figl M, Weninger P, Hofbauer M, Pezzei C, Schauer J, Leixnering M (2011) Results of dynamic treatment of fractures of the proximal phalanx of the hand. J Trauma 70(4):852–856CrossRefPubMed
6.
Zurück zum Zitat Franz T, von Wartburg U, Schibli-Beer S, Jung FJ, Jandali AR, Calcagni M, Hug U (2012) Extraarticular fractures of the proximal phalanges of the fingers: a comparison of 2 methods of functional, conservative treatment. J Hand Surg Am 37(5):889–898CrossRefPubMed Franz T, von Wartburg U, Schibli-Beer S, Jung FJ, Jandali AR, Calcagni M, Hug U (2012) Extraarticular fractures of the proximal phalanges of the fingers: a comparison of 2 methods of functional, conservative treatment. J Hand Surg Am 37(5):889–898CrossRefPubMed
7.
Zurück zum Zitat Kozin SH, Thoder JJ, Lieberman G (2000) Operative treatment of metacarpal and phalangeal shaft fractures. J Am Acad Orthop Surg 8:111–121CrossRefPubMed Kozin SH, Thoder JJ, Lieberman G (2000) Operative treatment of metacarpal and phalangeal shaft fractures. J Am Acad Orthop Surg 8:111–121CrossRefPubMed
8.
Zurück zum Zitat Eberlin K, Babushkina A, Neira J, Mudgal C (2014) Outcomes of closed reduction and periarticular pinning of base and shaft fractures of the proximal phalanx. J Hand Surg 39(8):1524–1528CrossRef Eberlin K, Babushkina A, Neira J, Mudgal C (2014) Outcomes of closed reduction and periarticular pinning of base and shaft fractures of the proximal phalanx. J Hand Surg 39(8):1524–1528CrossRef
9.
Zurück zum Zitat Shim WC, Yang JW, Roh SY, Lee DC, Kim JS (2014) Percutaneous cerclage wiring technique for phalangeal fractures. Tech Hand Up Extrem Surg 18(1):36–40CrossRefPubMed Shim WC, Yang JW, Roh SY, Lee DC, Kim JS (2014) Percutaneous cerclage wiring technique for phalangeal fractures. Tech Hand Up Extrem Surg 18(1):36–40CrossRefPubMed
10.
Zurück zum Zitat Khadim MF, Basheer MH (2013) A simple dynamic external fixator for complex phalangeal fractures. J Plast Surg Hand Surg 47(2):158–160CrossRefPubMed Khadim MF, Basheer MH (2013) A simple dynamic external fixator for complex phalangeal fractures. J Plast Surg Hand Surg 47(2):158–160CrossRefPubMed
11.
Zurück zum Zitat Margić K (2006) External fixation of closed metacarpal and phalangeal fractures of digits. A prospective study of one hundred consecutive patients. J Hand Surg Br 31(1):30–40CrossRefPubMed Margić K (2006) External fixation of closed metacarpal and phalangeal fractures of digits. A prospective study of one hundred consecutive patients. J Hand Surg Br 31(1):30–40CrossRefPubMed
12.
Zurück zum Zitat Hastings H II (1987) Unstable metacarpal and phalangeal fracture treatment with screws and plates. Clin Orthop 214:37–52 Hastings H II (1987) Unstable metacarpal and phalangeal fracture treatment with screws and plates. Clin Orthop 214:37–52
13.
Zurück zum Zitat Dabezies EJ, Schutte JP (1986) Fixation of metacarpal and phalangeal fractures with miniature plates and screws. J Hand Surg Am 11:283–288CrossRefPubMed Dabezies EJ, Schutte JP (1986) Fixation of metacarpal and phalangeal fractures with miniature plates and screws. J Hand Surg Am 11:283–288CrossRefPubMed
14.
Zurück zum Zitat Başar H, Başar B, Başçı O, Topkar OM, Erol B, Tetik C (2015) Comparison of treatment of oblique and spiral metacarpal and phalangeal fractures with mini plate plus screw or screw only. Arch Orthop Trauma Surg 135(4):499–504CrossRefPubMed Başar H, Başar B, Başçı O, Topkar OM, Erol B, Tetik C (2015) Comparison of treatment of oblique and spiral metacarpal and phalangeal fractures with mini plate plus screw or screw only. Arch Orthop Trauma Surg 135(4):499–504CrossRefPubMed
15.
Zurück zum Zitat Giesen T, Gazzola R, Poggetti A, Giovanoli P, Calcagni M (2016) Intramedullary headless screw fixation for fractures of the proximal and middle phalanges in the digits of the hand: a review of 31 consecutive fractures. J Hand Surg Eur 41(7):688–694CrossRef Giesen T, Gazzola R, Poggetti A, Giovanoli P, Calcagni M (2016) Intramedullary headless screw fixation for fractures of the proximal and middle phalanges in the digits of the hand: a review of 31 consecutive fractures. J Hand Surg Eur 41(7):688–694CrossRef
16.
Zurück zum Zitat Kodama N, Takemura Y, Ueba H, Imai S, Matsusue Y (2014) Operative treatment of metacarpal and phalangeal fractures in athletes: early return to play. J Orthop Sci 19(5):729–736CrossRefPubMed Kodama N, Takemura Y, Ueba H, Imai S, Matsusue Y (2014) Operative treatment of metacarpal and phalangeal fractures in athletes: early return to play. J Orthop Sci 19(5):729–736CrossRefPubMed
17.
Zurück zum Zitat Stern PJ, Weiser MJ, Reilley DG (1987) Complications of plate fixation in the hand skeleton. Clin Orthop 214:59–65 Stern PJ, Weiser MJ, Reilley DG (1987) Complications of plate fixation in the hand skeleton. Clin Orthop 214:59–65
18.
Zurück zum Zitat Page SM, Stern PJ (1998) Complications and range of motion following plate fixation of metacarpal and phalangeal fractures. J Hand Surg Am 23:827–832CrossRefPubMed Page SM, Stern PJ (1998) Complications and range of motion following plate fixation of metacarpal and phalangeal fractures. J Hand Surg Am 23:827–832CrossRefPubMed
19.
Zurück zum Zitat Ouellette EA, Freeland AE (1996) Use of the minicondylar plate in metacarpal and phalangeal fractures. Clin Orthop 327:38–46CrossRef Ouellette EA, Freeland AE (1996) Use of the minicondylar plate in metacarpal and phalangeal fractures. Clin Orthop 327:38–46CrossRef
20.
Zurück zum Zitat Kurzen P, Fusetti C, Bonaccio M, Nagy L (2006) Complications after plate fixation of phalangeal fractures. J Trauma 60(4):841–843CrossRefPubMed Kurzen P, Fusetti C, Bonaccio M, Nagy L (2006) Complications after plate fixation of phalangeal fractures. J Trauma 60(4):841–843CrossRefPubMed
21.
Zurück zum Zitat Trevisan C, Morganti A, Casiraghi A, Marinoni EC (2004) Low severity metacarpal and phalangeal fractures treated with miniature plates and screws. Arch Orthop Trauma Surg 124:675–680CrossRefPubMed Trevisan C, Morganti A, Casiraghi A, Marinoni EC (2004) Low severity metacarpal and phalangeal fractures treated with miniature plates and screws. Arch Orthop Trauma Surg 124:675–680CrossRefPubMed
22.
Zurück zum Zitat Brei-Thoma P, Vogelin E, Franz T (2015) Plate fixation of extra-articular fractures of the proximal phalanx: do new implants cause less problems? Arch Orthop Trauma Surg 135:439–445CrossRefPubMed Brei-Thoma P, Vogelin E, Franz T (2015) Plate fixation of extra-articular fractures of the proximal phalanx: do new implants cause less problems? Arch Orthop Trauma Surg 135:439–445CrossRefPubMed
23.
Zurück zum Zitat Omokawa S, Fuijitani R, Dohi Y, Okawa T, Yajima H (2008) Prospective outcomes of comminuted periarticular metacarpal and phalangeal fractures treated using a titanium plate system. J Hand Surg 33A:857–863CrossRef Omokawa S, Fuijitani R, Dohi Y, Okawa T, Yajima H (2008) Prospective outcomes of comminuted periarticular metacarpal and phalangeal fractures treated using a titanium plate system. J Hand Surg 33A:857–863CrossRef
24.
Zurück zum Zitat Shimizu T, Omokawa S, Akahane M, Murata K, Nakano K, Kawamura K, Tanaka Y (2012) Predictors of the postoperative range of finger motion for comminuted periarticular metacarpal and phalangeal fractures treated with a titanium plate. Injury 43(6):940–945CrossRefPubMed Shimizu T, Omokawa S, Akahane M, Murata K, Nakano K, Kawamura K, Tanaka Y (2012) Predictors of the postoperative range of finger motion for comminuted periarticular metacarpal and phalangeal fractures treated with a titanium plate. Injury 43(6):940–945CrossRefPubMed
25.
Zurück zum Zitat Agarwal AK, Pickford MA (2006) Experience with a new ultralow-profile osteosynthesis system for fractures of the metacarpals and phalanges. Ann Plast Surg 57(2):206–212CrossRefPubMed Agarwal AK, Pickford MA (2006) Experience with a new ultralow-profile osteosynthesis system for fractures of the metacarpals and phalanges. Ann Plast Surg 57(2):206–212CrossRefPubMed
26.
Zurück zum Zitat Onishi T, Omokawa S, Shimizu T, Fujitani R, Shigematsu K, Tanaka Y (2015) Predictors of postoperative finger stiffness in unstable proximal phalangeal fractures. Plast Reconstr Surg Glob Open 3(6):e431CrossRefPubMedPubMedCentral Onishi T, Omokawa S, Shimizu T, Fujitani R, Shigematsu K, Tanaka Y (2015) Predictors of postoperative finger stiffness in unstable proximal phalangeal fractures. Plast Reconstr Surg Glob Open 3(6):e431CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Tang JB (2009) Re: Levels of experience of surgeons in clinical studies. J Hand Surg Eur 34(1):137–8CrossRef Tang JB (2009) Re: Levels of experience of surgeons in clinical studies. J Hand Surg Eur 34(1):137–8CrossRef
28.
Zurück zum Zitat Marsh J, Slongo T, Agel J, Broderick S, Creevey W, DeCoster T, Prokuski L, Sirkin M, Ziran B, Henley B, Audige L (2007) Fracture and dislocation classification compendium: phalanx. J Orthop Trauma 21(Suppl 10):S82–S85 Marsh J, Slongo T, Agel J, Broderick S, Creevey W, DeCoster T, Prokuski L, Sirkin M, Ziran B, Henley B, Audige L (2007) Fracture and dislocation classification compendium: phalanx. J Orthop Trauma 21(Suppl 10):S82–S85
Metadaten
Titel
Dorsal versus lateral plate fixation of finger proximal phalangeal fractures: a retrospective study
verfasst von
Luke P. Robinson
Michael P. Gaspar
Adam B. Strohl
Seth L. Teplitsky
Shiv D. Gandhi
Patrick M. Kane
A. Lee Osterman
Publikationsdatum
24.02.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 4/2017
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-017-2650-x

Weitere Artikel der Ausgabe 4/2017

Archives of Orthopaedic and Trauma Surgery 4/2017 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.