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

Abstract

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 methodsThis 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. ConclusionsLow-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.

Comprehensive Review on Distal Femur Fractures: From Epidemiology to Treatment Strategies

“…The treatment approach and long-term functional outcomes diverge between intra-articular and extra-articular fractures. For instance, extra-articular fractures in hand fractures may exhibit superior total active motion and grip strength compared to intra-articular fractures, although statistical significance may not always be reached [19]. Moreover, the management of these fractures differs, with surgical intervention often required for intraarticular fractures, while certain extra-articular fractures may be amenable to conservative management [20].…”

Treating Little Finger’s Flexor Profundus Tendon Rupture after Percutaneous K-wire Fixation of a Bennet Fracture – A Case Report

“…About 20% of all fractures in the human skeleton involve the hand, affecting primarily the young and active population [ 1 ]. The Bennett’s Fracture (BF) is an intra-articular injury that occurs at the proximal aspect of the thumb metacarpal and is the most common fracture involving the carpometacarpal joint [ 2 ].…”

“…There is still controversy around the best treatment option. No consensus has been reached regarding the long-term clinical benefits of an anatomic reduction, although it seems that articular step-offs exceeding 2 mm can lead to malunion and consequently joint subluxation and arthritis [ 1 , 3 ]. Surgical management is generally advocated and popular surgical techniques include close reduction and fixation with Kirschner wires (K-wire) or open reduction and internal fixation, with screws and/or plates, often followed by cast immobilization [ 2 , 3 ].…”