Complications and range of motion following plate fixation of metacarpal and phalangeal fractures

1998 ◽  
Vol 23 (5) ◽  
pp. 827-832 ◽  
Author(s):  
Steven M. Page ◽  
Peter J. Stern
Keyword(s):  
Range Of Motion ◽  
Plate Fixation ◽  
Phalangeal Fractures

scholarly journals Analysis of Contoured Anatomic Plate Fixation versus Intramedullary Rod Fixation for Acute Midshaft Clavicle Fractures

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Juliann Kwak-Lee ◽  
Elke R. Ahlmann ◽  
Lingjun Wang ◽  
John M. Itamura
Keyword(s):  
Range Of Motion ◽  
Plate Fixation ◽  
Reoperation Rate ◽  
Healing Time ◽  
Implant Failure ◽  
Fracture Union ◽  
Early Results ◽  
Plate Group ◽  
Pin Fixation ◽  
Clavicle Fractures

The recent trend has been toward surgical fixation of displaced clavicle fractures. Several fixation techniques have been reported yet it is unclear which is preferable. We retrospectively reviewed one hundred one consecutive patients with acute midshaft clavicle fractures treated operatively at a level-1 trauma center. Thirty-four patients underwent intramedullary pin fixation and 67 had anatomic plate fixation. The outcomes we assessed were operative time, complications, infection, implant failure, fracture union, range of motion, and reoperation rate. There were 92 males and 9 females with an average age of 30 years (range: 14–68 years). All patients were followed to healing with an average followup of 20 months (range: 15–32 months). While fracture union by six months (P=0.8729) and range of motion at three months (P=0.6139) were similar, the overall healing time for pin fixation was shorter (P=0.0380). The pin group had more infections (P=0.0335) and implant failures (P=0.0245) than the plate group. Intramedullary pin fixation may have improved early results, but there was no long term difference in overall rate of union and achievement of full shoulder motion. The higher rate of implant failure with pin fixation may indicate that not all fracture patterns are amenable to fixation using this device.

scholarly journals Immobilization following Distal Radius Fractures: A Randomized Clinical Trial

2018 ◽  
Vol 07 (05) ◽  
pp. 409-414
Author(s):  
J. Hill ◽  
Gabriel Bouz ◽  
Ali Azad ◽  
William Pannell ◽  
R. Alluri ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Outcome Measures ◽  
Distal Radius ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Dash Score ◽  
Radius Fractures ◽  
Volar Plate Fixation

Background No consensus exists regarding postoperative splinting position following volar plate fixation of distal radius fractures. Purpose The purpose of this study was to determine whether immobilization in supination would result in superior outcomes compared with no restriction of forearm range of motion. Patients and Methods All patients >18 years of age with distal radius fractures indicated for volar plate fixation were eligible. Exclusion criteria were open fracture and concomitant injury to, or functional deficit of, either upper extremity. Patients were randomized to immobilization in (1) maximal supination with a sugar-tong splint or (2) no restriction of supination with a volar splint. Patient-Rated Wrist Evaluation (PRWE), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and visual analog scale (VAS) score; wrist range of motion; and grip strength were recorded at 2 and 6 weeks postoperatively. A Student's t-test was used to compare mean values of all outcome measures at each time point. Results A total of 46 patients enrolled in the study; 28 were immobilized with a volar splint and 18 were immobilized with a sugar-tong splint. Six-week follow-up data were obtained for 32 patients. There was no significant difference in PRWE, DASH, and VAS scores; or range of motion; or grip strength between the two groups postoperatively. Conclusion Range of motion, grip strength, and patient-rated outcome measures were similar regardless of postoperative immobilization technique in patients with a distal radius fractures stabilized with a volar plate. Surgeons can elect to use the standard-of-care postoperative immobilization modality of their preference following volar plate fixation without compromising short-term return to function. Level of Evidence This is a Level II, therapeutic study.

scholarly journals Internal Fixation of Displaced Intra-articular Fractures of the Hallux Through a Dorsomedial Approach: A Technical Tip

2017 ◽  
Vol 11 (1) ◽  
pp. 77-81 ◽  
Author(s):  
Danilo Ryuko Cândido Nishikawa ◽  
Fernando Aires Duarte ◽  
Cesar de Cesar Netto ◽  
Augusto César Monteiro ◽  
Rômulo Ballarin Albino ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Interphalangeal Joint ◽  
Rigid Fixation ◽  
Degenerative Arthritis ◽  
Soft Tissue Envelope ◽  
Articular Fractures ◽  
Extensor Hallucis Longus ◽  
Joint Fractures ◽  
Phalangeal Fractures ◽  
Type Of Injury

Phalangeal fractures of the toes represent common injuries of the forefoot. In the hallux, most fractures occur at the distal phalanx and frequently result from a direct crushing type of injury. Intra-articular fractures of the hallux are usually treated nonoperatively, except when the fragments are displaced and the joint is incongruent. Displaced fractures treated nonoperatively can result in degenerative arthritis of the interphalangeal joint, causing pain and range of motion limitation, hindering gait and weightbearing. The aim of this study was to present an option of operative approach in the treatment of displaced interphalangeal joint fractures of the hallux, along the medial border of the extensor hallucis longus tendon. It is our understanding that this approach minimizes injury to the soft tissue envelope, allowing a rigid fixation and early weightbearing and range of motion. Levels of Evidence: Level V: Expert opinion

scholarly journals Comparative study of plating versus conservative treatment in mid shaft fractures of clavicle

2021 ◽  
Vol 8 (1) ◽  
pp. 14
Author(s):  
Johney Juneja ◽  
Ankit Damor ◽  
A. K. Mehra ◽  
Anurag Talesra ◽  
Dharmendra Kumar Jatav ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Range Of Motion ◽  
Plate Fixation ◽  
Shoulder Function ◽  
Non Union ◽  
Scapular Fractures ◽  
Primary Plate ◽  
Early Primary ◽  
Function Range ◽  
Fracture Types

<p><strong>Background</strong>: Clavicle fractures represent up to 4% and 1% of all fractures, respectively. Historically, both fracture types have been treated conservatively with acceptable outcomes. The surgical correction of these fractures is currently being investigated as a viable alternative to conservative management.</p><p><strong>Methods</strong>: A systematic search of PubMed was performed to identify articles comparing open reduction and internal fixation (ORIF) with conservative treatment for clavicular fractures. Specific outcomes of interest were shoulder function, pain, strength, range of motion, and risk of non-union. </p><p><strong>Results</strong>: ORIF of midshaft clavicular fractures results in increased shoulder function within 6 weeks following treatment and a decreased risk of non-union. After 1 year, there was no longer a difference in shoulder function between groups. There was no difference in pain between treatment groups. Both ORIF and conservative treatment of extraarticular scapular fractures yield comparable results in shoulder function, range of motion, and strength following treatment.</p><p><strong>Conclusions</strong>: This study, early primary plate fixation of comminuted mid shaft clavicular fractures results in improved patient-oriented outcomes, improved surgeon-oriented outcomes, earlier return to function and decreased rates of non-union and malunion. </p>

scholarly journals The Use of the S-Quattro Dynamic External Fixator for the Treatment of Intra-Articular Phalangeal Fractures: A Review of the Literature

2012 ◽  
Vol 6 (1) ◽  
pp. 54-59 ◽  
Author(s):  
J.S Bhamra ◽  
W.S Khan ◽  
P Pastides
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Current Literature ◽  
External Fixator ◽  
Operative Time ◽  
Rigid Fixation ◽  
Review Of The Literature ◽  
Poor Functional Outcome ◽  
Younger Patients ◽  
Phalangeal Fractures

Intra-articular phalangeal fractures are a common injury. If left untreated, these injuries can lead to poor functional outcome with severe dehabilitating consequences, especially in younger patients.The S-Quattro external fixator device (Surgicraft®, UK) can be used to treat such injuries. Its use has been widely documented and has shown many advantages in comparison to other conventional treatments. Advantages include reduced operative time, rigid fixation and early range of motion.We present a review of the current literature and use of the S-Quattro serpentine system in the management of intraarticular phalangeal fractures.

Clinical outcomes of unstable metacarpal and phalangeal fractures treated with a locking plate system: a prospective study

2020 ◽  
Vol 45 (6) ◽  
pp. 582-587
Author(s):  
Takeshi Katayama ◽  
Kazuhiko Furuta ◽  
Hiroshi Ono ◽  
Shohei Omokawa
Keyword(s):  
Clinical Outcomes ◽  
Locking Plate ◽  
Plate Fixation ◽  
Bony Union ◽  
Complication Rates ◽  
Locking Plate Fixation ◽  
Level Of Evidence ◽  
Finger Motion ◽  
Phalangeal Fractures

We prospectively assessed clinical and radiological outcomes of locking plate fixation in treating unstable fractures in 11 metacarpals, 15 proximal phalanges, and eight middle phalanges in 34 consecutive patients from October 2011 to December 2016. Median length of follow-up was 14 months (range 12–24). The motion of finger joints, bony union, and complication rates were recorded. The median postoperative range of motion of the two interphalangeal joints and the metacarpophalangeal joint was 82% of the contralateral hands. Fractures in the three locations had significantly different recovery of the finger motion, with the best recovery for the metacarpal fractures. Closer distance between the plate edge and joint line was associated with a more limited range of the finger motion. The clinical outcomes approached an acceptable level at final follow-up. Finger stiffness is unavoidable after locking plate fixation of metacarpal and phalangeal fractures even with early hand therapy, with stiffness occurring in 10 out of 34 cases at the time of final follow-up 1 year after surgery. Level of evidence: II

Unstable phalangeal fractures: Treatment by A.O. screw and plate fixation

1991 ◽  
Vol 16 (1) ◽  
pp. 113-117 ◽  
Author(s):  
W.K. Pun ◽  
S.P. Chow ◽  
Y.C. So ◽  
K.D.K. Luk ◽  
W.K. Ngai ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Phalangeal Fractures

Open Reduction and Internal Fixation for Dorsal Fracture-dislocation of the Proximal Interphalangeal Joint

2020 ◽  
Vol 52 (01) ◽  
pp. 18-24
Author(s):  
Jun-Ku Lee ◽  
Yoon Seok Kim ◽  
Jin-Hyun Lee ◽  
Gyu-Chol Jang ◽  
Soo-Hong Han
Keyword(s):  
Range Of Motion ◽  
Screw Fixation ◽  
Plate Fixation ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Joint Fracture ◽  
Plate Group ◽  
Pip Joint ◽  
Distal Interphalangeal ◽  
Screw Group

Abstract Purpose The purpose of this study was to investigate and compare the clinical and radiological results of ORIF with inter-fragment screw or buttress plate fixation of acute PIP joint fracture dorsal dislocation. Patients and Methods Between January 2007 to December 2016, nineteen patients – 14 men and 5 women with an average age of 40.9 (19 to 64) years – were included in this study; 9 patients underwent small sized interfragmentary screw fixation and 10 patients underwent small buttress plating. The average follow-up period was 45.1 (13 to 78) months. Clinical assessment included measurement of range of motion (ROM) of the proximal and distal interphalangeal joint (PIP, DIP), grip and pinch strength, and pain with use of the Visual Analog Scale (VAS). At the postoperative X-ray, articular step off, gap, and degree of dorsal subluxation was measured, and maintenance of the reduction, fracture union, and the presence of degenerative changes were assessed. Results All patients achieved solid unions without instability. The overall average range of motion of PIP joint were from 9° to 85° (10–83° in the screw group, 8–87° in the plate group without significant difference). However, the screw group (average: 53°) presented more flexion in the distal interphalangeal joint than the plate group (average: 34°). Plate fixation can cause limited DIP flexion. Six of the ten patients from the plate group, underwent implant removal and two of these patients required PIP joint arthrolysis due to the PIP flexion contracture of more than 30°. Three of the nine patients in screw group underwent implant removal and two of the three patients required PIP joint arthrolysis. Conclusion Mini plate and screw fixation of acute PIP joint fracture dorsal dislocation can achieve comparable favorable clinical and radiographic outcomes through stable fixation and early range of motion exercise. Screw fixation, if possible, is probably preferable to plate fixation because of better DIP joint ROM and lower incidence of hardware removal. If there is a need for plate fixation the use of a short plate is recommended to avoid joint stiffness.

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