COMPLICATIONS AND RANGE OF MOTION FOLLOWING PLATE FIXATION OF METACARPAL AND PHALANGEAL FRACTURES

Eighty-two patients with 105 metacarpal and/or phalangeal fractures st abilized with plates were retrospectively reviewed to assess complicat ions and outcomes. Despite stable fixation and early mobilization, maj or complications were encounterec in 36% of fractures, especially with phalangeal and open fractures. Complications included stiffness, nonu nion, plate prominence, infection, and tendon rupture. Forty-eight of 63 (76%) metacarpal fractures and 44 of 66 (67%) closed fractures had a final range of motion greater than 220 degrees; however, only 4 of 3 7 (11%) phalangeal fractues and 8 of 34 (24%) open fractures achieved this outcome. Despite technical advances in plate design and instrumen tation, including lower-profile titanium plates, complications occur c ommonly with metacarpal and phalangeal fractures, leading to a high in cidence of unsatisfactory results. We do not condemn plate fixation, a nd attribute many of our unsatisfactory results to the frequent use of plates in open and phalangeal fractures. Copyright (C) 1998 by the Am erican Society for Surgery of the Hand.