Brei-Thoma, Pascale Bernadette; Vögelin, Esther; Franz, Torsten (2015). Plate fixation of extra-articular fractures of the proximal phalanx: do new implants cause less problems? Archives of orthopaedic and trauma surgery, 135(3), pp. 439-445. Springer 10.1007/s00402-015-2155-4
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BACKGROUND
Limited range of finger motion is a frequent complication after plate fixation of phalangeal fractures. The purpose of this study was to evaluate the results of plate fixation of extra-articular fractures of the proximal phalanx using current low-profile mini-fragment-systems.
METHODS
From 2006 to 2012, 32 patients with 36 extra-articular fractures of the proximal phalanx of the triphalangeal fingers were treated with open reduction and plate fixation (ORPF) using 1.2 and 1.5 mm mini-fragment systems. Patients presenting with open fractures grade 2 and 3 or relevant laceration of adjacent structures were excluded from the study. We retrospectively evaluated the rate of mal-union or non-union after ORPF, the need for revision surgery, for plate removal, and for tenolysis. Data were analyzed for further complications with regard to infections or complex regional pain syndrome (CRPS).
RESULTS
No infections were noted. Five patients developed transient symptoms of CRPS. Six weeks postoperatively, total active finger motion (TAM) averaged 183°, and all 32 patients underwent formal hand therapy. At the latest follow-up or at the time of plate removal, respectively, the mean TAM improved to 213°. Extension lag of proximal interphalangeal joints was found in 67 % of all fractured fingers. Secondary surgery was necessary in 14 of 32 patients (2 corrective osteotomies, 12 plate removals including 7 procedures explicitly because of reduced mobility).
CONCLUSIONS
Despite of new implant designs significant problems persist. Adhesions of extensor tendons leading to limited range of finger motion are still the most frequent complications after ORPF of proximal phalangeal fractures, even in absence of significant soft-tissue damage.
LEVEL OF EVIDENCE
Therapeutic, Retrospective, Level IV.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Handchirurgie 04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Hand Surgery |
UniBE Contributor: |
Brei-Thoma, Pascale Bernadette, Vögelin, Esther, Franz, Torsten |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0936-8051 |
Publisher: |
Springer |
Language: |
English |
Submitter: |
Veronika Picha |
Date Deposited: |
27 Jul 2015 16:33 |
Last Modified: |
05 Dec 2022 14:48 |
Publisher DOI: |
10.1007/s00402-015-2155-4 |
PubMed ID: |
25577241 |
BORIS DOI: |
10.7892/boris.70383 |
URI: |
https://boris.unibe.ch/id/eprint/70383 |
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