Complications of plate fixation in metacarpal fractures
Cesare Fusetti1, Henning Meyer, Nicola Borisch
1Hand Surgery Unit, Division for Reconstructive Surgery, University Hospital of Geneva, Geneva, Switzerland.
Background:
The objective of this study is to assess the complications after open reduction and plate fixation of extra-articular metacarpal fractures.
Methods:
We retrospectively reviewed the clinical and radiologic records of 129 consecutive patients with 157 metacarpal fractures treated by open reduction and internal fixation with plates between 1993 and 1999. Intra-articular fractures and fractures of the thumb metacarpal were excluded. Eighty-one patients (64 men and 17 women) with 104 fractures were available for review, at an average follow-up of 13.6 months (range, 6-27 months).
Results:
Twenty-eight patients (35%) and 33 fractures (32%) had one or more complications, including difficulty with fracture healing (12 patients [15%]), stiffness (eight patients [10%]), plate loosening or breakage (seven patients [8%]), complex regional pain syndrome (two patients), and one patient who developed a deep infection.
Conclusion:
Despite technical advances in implant material, design, and instrumentation, plate fixation of metacarpal fractures remains fraught with complications and unsatisfactory results.
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