Long-Term Functional Results of Intra- and Extra-Articular Hand Fractures Treatment With Titanium Miniature Plates and Screws With Minimum Follow-Up of 24 Months

Cureus. 2021 Jun 4;13(6):e15438. doi: 10.7759/cureus.15438. eCollection 2021 Jun.

Abstract

Introduction The purpose of this study was to evaluate the long-term outcome of an extended range of hand fractures treated with titanium, low profile plates, and screws. Materials and methods This retrospective study included adult patients with at least one phalangeal and/or metacarpal fracture, treated with mini titanium plates and screws, between 2004-2016, in a single trauma center, that were followed-up for at least 24 months and with complete, intact medical records. Results 90 patients (79 men and 11 women) with 114 hand (46 phalangeal, 68 metacarpal) fractures fulfilled the inclusion criteria. Thirty-two fractures were open (28.07%), 27 were intra-articular (23.68%), and 12 were both open and intra-articular fractures. The mean age of the patients was 36.02 years (range 17-75). Mean follow-up was 95.3 months (range 24 to 138). Open fractures had a reduced mean grip strength and total active motion. No difference was observed between intra-articular and extra-articular fractures (for grip strength and total active motion). Predictors of the final outcome included the severity of the initial injury (open vs closed) and not the anatomic location (intra- or extra-articular, metacarpal, or phalangeal) of the fracture. Conclusions Low-profile plates and screws can successfully be used to establish union and restore the alignment of the fractured bone while achieving a satisfactory clinical outcome, even in cases of open or intra-articular fractures.

Keywords: hand fractures; internal fixation; metacarpal fractures; phalangeal fractures; plates; screws; trauma.