Comparison of Metacarpal Plating Methods

Biomechanical Comparison of Double-Row Locking Plates Versus Single- and Double-Row Non-Locking Plates in a Comminuted Metacarpal Fracture Model

“…6 In our previous study, we showed that the shorter double-row 3-dimensional non-locking plates offer greater stiffness and stability compared with single-row nonlocking plates in a simple transverse fracture model. 17 If this finding becomes clinically relevant, it could lead to less invasive procedures with shorter incisions, minimal soft tissue dissection, and less tendon exposure to hardware without compromising the quality of the fixation. This may decrease the incidence of complications such as tendon irritation, tendon rupture, finger stiffness, and plate removal, all of which have been reported in the literature with plate and screw fixation.…”

“…17 The double-row plates are shorter, and their configuration was thought to provide added stability similar to the 90-90 double-plate fixation construct that is often used in complex and severely comminuted distal humerus and distal radius fractures. 18,19 This finding may eventually lead to less invasive procedures with shorter incisions, limited soft tissue dissection, and decreased scarring and soft tissue complications postoperatively.…”

Metacarpal fractures in the athlete

“…A smaller study of open or closed fractures of the metacarpals and phalanges showed equally good results using less prominent plates of 0.6 mm compared to 1.3 mm thickness, without any cases of tendon rupture, nonunion, or hardware removal among the 21 metacarpal fractures [15]. Also, biomechanical studies of newer constructs, including locking plates, shorter length plates, double-row plates (sometimes called "cage," "ladder," or "three-dimensional"), and smaller dual orthogonal plates demonstrate equivalent or superior fixation to standard constructs, thus potentially minimizing soft tissue dissection and/or hardware prominence [16][17][18][19].…”

Non-Locked and Locked Plating Technology for Hand Fractures

“…Two recent biomechanical studies have shown that double-row, non-locking plates with 3 bicortical screws on either side of the fracture will achieve fixation with a higher bending and torsional stiffness and load to failure than standard single-row plates. 6,8 The overall rate of complications after nonlocking plate fixation of unstable metacarpal and phalangeal fractures varies widely in the literature, but is reported to be as high as 36%. The most common complications are finger stiffness, extensor lag, and joint contracture.…”