Outcomes of low-profile plate-screw osteosynthesis in unstable extra-articular fractures of the proximal phalanx

Abstract

In this study, we aimed to present radiologic and functional outcomes of extra articular proximal phalangeal fractures treated with low profile plate and screw osteosynthesis. The study included 20 patients who had undergone osteosynthesis with low profile plate and non-locking screws due to extra-articular closed proximal phalangeal instable fractures. Clinical and radiologic data were evaluated retrospectively. Postoperative 6th month follow up data were obtained and statistically analyzed. Active and passive range of motion of the metacarpophalangeal and interphalangeal joint; total active motion grip strength of injured and uninjured visual analog scale for pain DASH score have been evaluated, distance between pulpa and palmar curve is measured. Belsky score, presence of reoperation and complications were noted. The mean time to radiologic union was 4.2 (3-6) weeks. Functional evaluation of the patients revealed a mean MCF flexion of 87.3 (75-90), a mean PIP flexion of 94.3 (65-100), mean DIP flexion of 77.6 (75-80), mean total active motion of 259 (210-270) degrees. Grip strength in the injured hand was 52.7 (40-58) kgw, and in the uninjured hand it was 54.4 (42-60) kgw. There was no statistically significant difference in grip strenght (p<0.05). The mean visual analogue scale score was 0.8 (0-2). The mean DASH score was 7 (2-27) and the mean distance between pulpa and palmar curve was 3 (0-8) mm. Open reduction and low-profile plate and screw fixation of proximal phalangeal fracture in treatment of unstable extra-articular fractures of the proximal phalanx with early rehabilitation yields satisfactory functional and radiologic outcomes.

Keywords

• proximal phalanx,fracture,unstable,extra-articular

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