[Mini condylar plate osteosyntheses of the hand]

The mini condylar plate fixation system is a new method for stable internal metaphyseal bone fixation about the MP and PIP joint areas of the hand. Indications for its use are rigid stabilization of fractures, osteotomies, and bony components of composite tissue transfers. The device should be used in deference to other techniques when early active range of motion is pursued. Its best use is in the face of combined injuries, or osteotomies with tenolysis/capsulotomy. The advantages of this implant's design permit stabilization of small epiphyseal fragments with minimal interference of joint function and perhaps a reduction of irritation of the extensor aponeurosis. Disadvantages include the need for careful preoperative planning because of this implant's small size and unforgiving tolerances of application. The data is included for the first 87 consecutive cases of its use. Despite the institution of range of motion therapy within five days in 77% of the cases, there were no nonunions. Two cases of delayed union were successfully treated by addition of cancellous bone grafts without revision of the fixation devices. Problems included malalignments (three cases), infection (two cases), and soft tissue coverage (four cases). Aseptic necrosis of bone is associated with metacarpal head fractures and is seen with the use of this implant in treating such intraarticular fractures. The final digital performance was analysed but has not been presented because of the multiplicity of the associated joint, tendon, vascular, nerve, and skin involvement.