Comparison of Clinical Outcomes of Phalangeal Fracture Treated with Dorsolateral Approach or Post-middle Approach Using AO Mini Titanium Plate

Abstract

The aim of this study is to investigate the clinical outcomes of various fixation methods for proximal phalangeal fractures with Arbeitsgemeinschaft für Osteosynthesefragen (AO) mini titanium plate by dorsolateral approach or post-middle approach. Clinical results of 62 fingers of 53 patients with proximal phalangeal fracture were evaluated. For dorsolateral approach, the lateral bundle of the extensor tendon was drawn away to expose the fracture part of the bone. After reduction, the plate was located at the dorsolateral side of the bone. For post-middle approach, the extensor tendon was split to expose the fracture part of the bone. After reduction, the plate was fixed to the proximal phalangeal side of the bone, and the extensor tendon was repaired with 3-0 nonabsorbable silk sutures. We found low overall complication rates in both groups. The mean total active motion (TAM) for the dorsolateral group and post-middle group was 234.60° ± 22.63° and 221.08° ± 25.69°, respectively. There was a statistical significance between the two groups (P = 0.037 < 0.05), indicating that TAM was notably affected by various fixation methods. With AO mini titanium plate, movement in dorsolateral approach group was significantly higher than in post-middle approach group. Dorsolateral approach is an acceptable technique of incision for proximal phalangeal fractures.

Ekstraartiküler Proksimal Falanks Kırıklarında Kapalı Redüksiyon ve Kirschner Teli Tespitin Klinik ve Radyolojik Sonuçları

“…There was no statistically significant difference between the grip strengths (p<0.05). The functional evaluation parameters (VAS 0.8 (0-2), DASH 7 (2-27), finger pulp and finger curve distance 3 (0-8) mm) were similar to the comparative studies in the literature (11,21). We achieved excellent results in 4 patients, good in 9 patients, and poor results in 3 patients in Belsky scores.…”

“…There are no absolute contraindications of K wire fixation. Relative contraindications are intra-articular comminuted fractures, lack of soft tissue coverage and increased functional expectations of the patients (2,11,20,21).…”

“…Leaving the ends of the wires on the skin may lead to cosmetic problems. Depending on the surgical treatment and period of immobilization; extensor tendon adhesions or poor functional outcomes can develop (11,(21)(22)(23). Closed reduction and K wire fixation can cause rehabilitation to be delayed because of skin irritation.…”

Comparison of Miniplate and K-wire in the Treatment of Metacarpal and Phalangeal Fractures

“…The miniplate, however, has modifications specially designed for hand surgery. Through the use of these specially designed plates, we can achieve extra rigidity and length maintenance [9,10].…”