Background: Stable internal screw/plating systems for hand fractures have evolved during the last 20 years. The improved versatility leads to the increased use of these materials in open fractures, with the benefit of early mobilization. The aim of this retrospective study is to discern whether the broadening of the indications for these implants is accompanied by increased complication rates.
Methods: Data from 365 patients treated during the last 10 years at our department for metacarpal or phalangeal fractures with stable internal fixation by screw or plate were gathered and analyzed.
Results: Uneventful bony consolidation was observed in 91.2% (n = 333). The functional results were excellent to acceptable in 85.2%, whereas in 14.8% (n = 54), the result was unsatisfactory, the latter group presenting with concominant soft tissue injury. There was no statistically significant difference in infection and nonunion rates when comparing open and closed fractures.
Conclusion: These results confirm that most patients with open metacarpal and phalangeal fractures can be treated by stable internal fixation.
From the Departments of Plastic and Hand Surgery (H.B., A.K.H., N.I., A.M., G.B.S.), and Medical Biometry and Statistics (J.S.-M.), University of Freiburg Medical Center, Freiburg, Germany.
Submitted for publication October 15, 2008.
Accepted for publication March 25, 2009.
The authors declare that they do not have any commercial interests and that they have not received any sort of financial or material support in respect to the matters presented in this article.
Address for reprints: Holger Bannasch, MD, Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Hugstetter Strasse 55, 79106 Freiburg, Germany; email: holger.bannasch@uniklinik-freiburg.de.
