Complications of plate fixation in the hand skeleton

Plate fixation of metacarpal and phalangeal fractures is designed to provide rigid internal fixation in order to facilitate early motion and thereby minimize joint and tendon complications. In a series of plate fixations, 16 of 38 (42%) of proximal phalangeal and metacarpal shaft fractures developed complications of stiffness, malunion, nonunion, and tendon rupture. Complications occurred more frequently for phalangeal than for metacarpal fractures and more frequently when there were associated bone or soft tissue injuries. The technique is demanding and secondary procedures are frequently required.